Information Collection

Interview Tech End-Users

IC 221666 under ICR 201605-0925-005 · OMB 0925-0720.

Documents and Forms

Document Name Document Type
Form 3 Interview Tech End-Users Form and Instruction
3 Technology End User Interview Guide Attachment 2_Technology End User Interview Guide_Mar2016.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Interview Tech End-Users	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3	Technology End User Interview Guide	Attachment 2_Technology End User Interview Guide_Mar2016.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.