Information Collection

NCCCP Annual Key Informant Interview

IC 261242 under ICR 202307-0920-003 · OMB 0920-0841.

Documents and Forms

Document Name Document Type
Form 0920-0841 NCCCP Annual Key Informant Interview Form and Instruction
0920-0841 NCCCP Annual Key Informant Interview 0920-0841_Attachment 3b. Key Informant Interview consent and scripts.docx Form and Instruction
0920-0841 NCCCP Annual Key Informant Interview 0920-0841_Attachment 3b. Key Informant Interview consent and scripts.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NCCCP Annual Key Informant Interview	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	0920-0841	NCCCP Annual Key Informant Interview	0920-0841_Attachment 3b. Key Informant Interview consent and scripts.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	162	162
Annual IC Time Burden (Hours)	243	243
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.