Information Collection

Grantee leadership

IC 244140 under ICR 202010-0935-002 · OMB 0935-0259.

Documents and Forms

Document Name Document Type
Form 5 Grantee leadership Form and Instruction
5 Attachment E: Member Checking Session to Validate QI Inf Attachment E.DOCX Form and Instruction
5 Attachment E: Member Checking Session to Validate QI Inf Attachment E.DOCX Form and Instruction
6 Attachment F: Member Checking Sessions 2 and 3 to Valida Attachment F.DOCX Form and Instruction
6 Attachment F: Member Checking Sessions 2 and 3 to Valida Attachment F.DOCX Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Grantee leadership	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	5	Attachment E: Member Checking Session to Validate QI Infrastructure Models and Typology of QI Support Interventions	Attachment E.DOCX		Yes	Yes	Fillable Fileable
Form and Instruction	6	Attachment F: Member Checking Sessions 2 and 3 to Validate Qualitative and Mixed-Methods Findings	Attachment F.DOCX		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

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.