Information Collection

Interviews

IC 227988 under ICR 201612-0990-003 · OMB 0990-0462.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OWH_Draft KII Guide_081517.docx	Other-guide interview
OWH_OMB KII Intro Letter_081517.docx interview	IC Document

IC Title:

Interviews

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Other-guide interview			OWH_Draft KII Guide_081517.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	40	40
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
interview	OWH_OMB KII Intro Letter_081517.docx	08/22/2017

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