Information Collection

NCCCP Annual Key Informant Interview

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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	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 %

table that charts list of burden
	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

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.