Information Collection

Case Study Interview of DP13-1315 Partner

IC 226624 under ICR 202004-0920-020 · OMB 0920-1193.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1193 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Case Study Interview Guide for DP13-1315 Partners Case Study Interview of DP13-1315 Partner	Form and Instruction
Case Study Interview Guide for DP13-1315 Partners Att 9b_Case Study Interview Guides for DP13-1315 Partners.docx	Form and Instruction

IC Title:

Case Study Interview of DP13-1315 Partner

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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				No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-2	2
Annual IC Time Burden (Hours)	-2	2
Annual IC Cost Burden (Dollars)	-77	77

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.

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