In-depth Interview with Selected Respondents to the Web-based Survey

Assessing the Impact of Targeted Training and Technical Assistance Efforts on the Implementation of Comprehensive Cancer Control

⚠️ Notice: This information collection may be referencing outdated material.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
In-depth Interview with Selected Respondents to the Web-based Survey Form and Instruction
In-Depth Interview Guide Att 11b_In depth Interview Guide.docx Form and Instruction
Att 11a_Indepth Interview Introductory_Recruitment Email.docx Recruitment Email for In-depth Interviews IC Document

Information Collection (IC) Details

IC Title:	In-depth Interview with Selected Respondents to the Web-based Survey	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	In-Depth Interview Guide	Att 11b_In depth Interview Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	141	141

Documents for IC

Title	Document	Date Uploaded
Recruitment Email for In-depth Interviews	Att 11a_Indepth Interview Introductory_Recruitment Email.docx	05/01/2017

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