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CCC Staff Key Informant Recruitment/Scheduling
Experiences with the Implementation and Outcomes of Policy and Environmental Cancer Control Interventions
OMB: 0920-1016
IC ID: 210385
OMB.report
HHS/CDC
OMB 0920-1016
ICR 201510-0920-001
IC 210385
( )
Documents and Forms
Document Name
Document Type
Form 0920-
CCC Staff Key Informant Recruitment/Scheduling
Form and Instruction
0920- Att D4_Key_Informant_Recruitment Scheduling
Att D4_Key_Informant_Recruitment Scheduling_10_29_13.docx
Form and Instruction
Att D1_Key_Informant_Interview_11_01_13.docx
Att D1_Key_Informant_Interview
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CCC Staff Key Informant Recruitment/Scheduling
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 and Instruction
0920-
Att D4_Key_Informant_Recruitment Scheduling
Att D4_Key_Informant_Recruitment Scheduling_10_29_13.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12
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
12
0
0
0
0
12
Annual IC Time Burden (Hours)
1
0
0
0
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att D1_Key_Informant_Interview
Att D1_Key_Informant_Interview_11_01_13.docx
02/11/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.