Grantee Interview

Strategic Prevention Framework for Prescription Drugs (SPF Rx)

Documents and Forms

Document Name Document Type
Form Grantee Interview Grantee Interview Form and Instruction
Form Grantee Interview Grantee Interview Form and Instruction
Grantee Interview Grantee Interview Attachment 4 SPF-RX Grantee Interview CLEAN - 13July2022.docx Form and Instruction
Grantee Interview Grantee Interview Attachment 4 SPF-RX Grantee Interview CLEAN - 13July2022.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Grantee Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	Grantee Interview	Grantee Interview	Attachment 4 SPF-RX Grantee Interview CLEAN - 13July2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	13	13
Annual IC Time Burden (Hours)	19	19
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.