CCL Partner Site-Level Informant Interview

National Evaluation of the DP18-1815 Cooperative Agreement Program: Category B, Cardiovascular Disease Prevention and Management

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1311 can be found here:

Documents and Forms

Document Name Document Type
CCL Partner Site-Level Informant Interview Form and Instruction
CCL Partner-Site Key Informant Interview Guide Att 4l. CCL Part Site Inform Interview Guide.docx Form and Instruction

Information Collection (IC) Details

IC Title:	CCL Partner Site-Level Informant Interview	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	CCL Partner-Site Key Informant Interview Guide	Att 4l. CCL Part Site Inform Interview Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	870	870

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.