Information Collection

Case Study Interview of DP13-1315 Partner

IC 226624 under ICR 201703-0920-006 · OMB 0920-1193.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1193 can be found here:

Documents and Forms

Document Name Document Type
Case Study Interview of DP13-1315 Partner Form and Instruction
Case Study Interview Guide for DP13-1315 Partners Att 9b_Case Study Interview Guides for DP13-1315 Partners.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Case Study Interview of DP13-1315 Partner	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	N/A	Case Study Interview Guide for DP13-1315 Partners	Att 9b_Case Study Interview Guides for DP13-1315 Partners.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	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	2	2
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	77	77

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.