Information Collection

Individual Interview Questions (Feature Stories)

IC 217715 under ICR 201511-0925-006 · OMB 0925-0729.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 7 Individual Interview Questions (Feature Stories)	Form and Instruction
Attachment P_Web-Based Resource Screenshots (Feature Stories).pdf	Other-screenshot
7 Attachment B Individual Interview Questions (Feature Sto Attachment B_Individual Interview Questions (Feature Stories).docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	7	Attachment B Individual Interview Questions (Feature Stories)	Attachment B_Individual Interview Questions (Feature Stories).docx		Yes	Yes	Fillable Fileable
Other-screenshot			Attachment P_Web-Based Resource Screenshots (Feature Stories).pdf		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.