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Affiliated Partner Telephone Interview Guide
State and Community Tobacco Control (SCTC) Research Initiative Evaluation (NCI)
OMB: 0925-0707
IC ID: 213444
OMB.report
HHS/NIH
OMB 0925-0707
ICR 201410-0925-003
IC 213444
( )
Documents and Forms
Document Name
Document Type
Form 3
AFFILIATED PARTNER TELEPHONE INTERVIEW GUIDE
Form
3 AFFILIATED PARTNER TELEPHONE INTERVIEW GUIDE
Attachment 4.Affiliated Partners Telephone Interview Guide.8-20-14.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
AFFILIATED PARTNER TELEPHONE INTERVIEW GUIDE
Agency IC Tracking Number:
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
3
AFFILIATED PARTNER TELEPHONE INTERVIEW GUIDE
Attachment 4.Affiliated Partners Telephone Interview Guide.8-20-14.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
21
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
21
0
21
0
0
0
Annual IC Time Burden (Hours)
14
0
14
0
0
0
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.