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Cost Study Interview Guide_Recipient (Attachment 5c)
[NCCHPHP] Comprehensive Evaluations of the WISEWOMAN Programs, The National Cardiovascular Health Program, The Innovative Cardiovascular Health Program
OMB: 0920-1453
IC ID: 272038
OMB.report
HHS/CDC
OMB 0920-1453
ICR 202504-0920-030
IC 272038
( )
Documents and Forms
Document Name
Document Type
Form 0920-24FI
Cost Study Interview Guide_Recipient (Attachment 5c)
Form and Instruction
Form 0920-24FI
Cost Study Interview Guide_Recipient (Attachment 5c)
Form and Instruction
0920-24FI Cost Study – Recipient Interview Guide
Att 5c. Cost Study_Interview Guide_Recipient.docx
Form and Instruction
0920-24FI Cost Study – Recipient Interview Guide
Att 5c. Cost Study_Interview Guide_Recipient.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cost Study Interview Guide_Recipient (Attachment 5c)
Agency IC Tracking Number:
0920-24FI
Is this a Common Form?
No
IC Status:
Unchanged
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
0920-24FI
Cost Study – Recipient Interview Guide
Att 5c. Cost Study_Interview Guide_Recipient.docx
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:
37
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
37
0
0
0
0
37
Annual IC Time Burden (Hours)
37
0
0
0
0
37
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.