Information Collection

Qualitative Interview: Collaborative Process Evaluation (THRIVE Awardees)

IC 224635 under ICR 201801-0920-001 · OMB 0920-1178.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1178 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 5 Qualitative Interview Collaborative Process Evaluation 11 22 16 FINAL.docx	Instruction

IC Title:

Qualitative Interview: Collaborative Process Evaluation (THRIVE Awardees)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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
Instruction			Attachment 5 Qualitative Interview Collaborative Process Evaluation 11 22 16 FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	7	7
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	121	121

Documents for IC

table that charts IC Documents
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.