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WTC Leadership
The World Trade Center Health Program: Impact Assessment and Strategic Planning for Translational Research (Part 1, Formative Research: Focus Groups)
OMB: 0920-1252
IC ID: 234100
OMB.report
HHS/CDC
OMB 0920-1252
ICR 201911-0920-009
IC 234100
( )
Documents and Forms
Document Name
Document Type
WTC Leadership
Form and Instruction
Brief Demographic Survey
Att G_Brief Demo Survey_2018-11-14.pdf
Form and Instruction
Focus group guide
WTCHP Att D_FG protocol_2019-11.22.19 for OMB_clean.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
WTC Leadership
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Brief Demographic Survey
Att G_Brief Demo Survey_2018-11-14.pdf
No
Paper Only
Form and Instruction
none
Focus group guide
WTCHP Att D_FG protocol_2019-11.22.19 for OMB_clean.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Disaster Preparedness and Planning
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
20
0
0
0
0
20
Annual IC Time Burden (Hours)
40
0
0
0
0
40
Annual IC Cost Burden (Dollars)
1,229
0
0
0
0
1,229
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.