Information Collection

CCL Partner Site-Level Informant Interview

IC 241439 under ICR 202003-0920-010 · OMB 0920-1311.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.