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Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)
[NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program
OMB: 0920-1453
IC ID: 271846
OMB.report
HHS/CDC
OMB 0920-1453
ICR 202504-0920-030
IC 271846
( )
Documents and Forms
Document Name
Document Type
Form 0920-1453
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)
Form and Instruction
Form 0920-1453
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)
Form and Instruction
0920-1453 Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_r
Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_clean.docx
Form and Instruction
0920-1453 Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_r
Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_clean.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ex Assessment TBC Recipient Interview Guide_WW (Attachment 4g)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
0920-1453
Att 4g. Ex Assessment_TBC_Recipient_Interview Guide_WW_rev 2025
Att 4g. Ex 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
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2
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
2
0
0
0
0
2
Annual IC Time Burden (Hours)
3
0
0
0
0
3
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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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.