Information Collection

Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)

IC 272079 under ICR 202410-0920-005 · OMB 0920-1453.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1453 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-24FI Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)	Form and Instruction
0920-24FI In-Depth Assessment – Evaluability Assessment Learning C Att 3c. Eval Assessment_LC_Interview Guide_NCHP_ICHP.docx	Form and Instruction
0920-24FI In-Depth Assessment – Evaluability Assessment Learning C Att 3c. Eval Assessment_LC_Interview Guide_NCHP_ICHP.docx	Form and Instruction

IC Title:

Eval Assessment LC Interview Guide_NCHP_ICHP (Attachment 3c)

Agency IC Tracking Number:

0920-24FI

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	0920-24FI	In-Depth Assessment â Evaluability Assessment Learning Collaborative Interview Guide â The National Cardiovascular Health Program & The Innovative Cardiovascular Health Program	Att 3c. Eval Assessment_LC_Interview Guide_NCHP_ICHP.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

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	12	12
Annual IC Time Burden (Hours)	12	12
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.