Information Collection

State Systems interview guide for State Coordinating Center

IC 209770 under ICR 202306-0915-005 · OMB 0915-0335.

Documents and Forms

Document Name Document Type
Attachment F. SPHARC Interview Guide.docx Other-Interview Guide
Attachment F. SPHARC Interview Guide.docx Other-Interview Guide

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Systems interview guide for State Coordinating Center	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
Other-Interview Guide			Attachment F. SPHARC Interview Guide.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

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: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	-5	6
Annual IC Time Burden (Hours)	2	-4	6
Annual IC Cost Burden (Dollars)	0	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.