Information Collection

Qualitative Interviews

IC 222627 under ICR 201607-0930-002 · OMB 0930-0371.

Documents and Forms

Document Name Document Type
Form Qualitative Interv Qualitative Interviews Form and Instruction
Qualitative Interv Qualitative Interview Protocol 4__Attachment 4 - MHFA evaluation - Qualitative Interview Protocol.pdf Form and Instruction
8__Attachment 8 - MHFA Evaluation consent form for interviews 2 24 16.pdf Qualitative Interview Consent Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Qualitative Interviews	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	Qualitative Interview Protocol	Qualitative Interview Protocol	4__Attachment 4 - MHFA evaluation - Qualitative Interview Protocol.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 23	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	23	23
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Qualitative Interview Consent Form	8__Attachment 8 - MHFA Evaluation consent form for interviews 2 24 16.pdf	07/26/2016

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