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Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m)

IC 271842 under ICR 202504-0920-030 · OMB 0920-1453.

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Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
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Eval Assessment CCL Recipient Interview Guide WW (Attachment 3m)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1453 Att 3m. Eval Assessment_CCL_Recipient_Interview Guide_WW_rev 2025 Att 3m. Eval Assessment_CCL_Recipient_Interview Guide_WW_clean.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3 0
   
State, Local, and Tribal Governments
 
   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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