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Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)
[NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program
OMB: 0920-1453
IC ID: 271840
OMB.report
HHS/CDC
OMB 0920-1453
ICR 202504-0920-030
IC 271840
( )
Documents and Forms
Document Name
Document Type
Form 0920-1453
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)
Form and Instruction
Form 0920-1453
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)
Form and Instruction
0920-1453 Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW
Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW_clean.docx
Form and Instruction
0920-1453 Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW
Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW_clean.docx
Form and Instruction
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IC Title:
Eval Assessment TBC Recipient Interview Guide WW (Attachment 3i)
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Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
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Form and Instruction
0920-1453
Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW_rev 2025
Att 3i. Eval Assessment_TBC_Recipient_Interview Guide_WW_clean.docx
N/A
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
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Number of Respondents:
3
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3
0
0
0
0
3
Annual IC Time Burden (Hours)
5
0
0
0
0
5
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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