Case Study Interview for TTA Provider Evaluators

Assessment of Technical Assistance and Training Approaches to Accelerate Comprehensive Cancer Control Outcomes

Documents and Forms

Document Name Document Type
Case Study Interview for TTA Provider Evaluators Form and Instruction
Case Study Interview Guide for TTA Provider Evaluators Att 4e. Case Study Interview Guide for TTA Provider Evaluators.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Case Study Interview for TTA Provider Evaluators	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	Case Study Interview Guide for TTA Provider Evaluators	Att 4e. Case Study Interview Guide for TTA Provider Evaluators.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	29	29

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.