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Staff Interview
[NCHHSTP] Evaluation of Safe Spaces in CDC-directly funded Community-based Organizations (CBOs)
OMB: 0920-1403
IC ID: 257787
OMB.report
HHS/CDC
OMB 0920-1403
ICR 202212-0920-002
IC 257787
( )
Documents and Forms
Document Name
Document Type
Form 0920-
Staff Interview
Form and Instruction
0920- Staff Interviews
Att 5_ Staff Interview.docx
Form and Instruction
0920- Staff Interviews
Att 5_ Staff Interview.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Staff Interview
Agency IC Tracking Number:
0920-22IJ
Is this a Common Form?
No
IC Status:
New
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-
Staff Interviews
Att 5_ Staff Interview.docx
No
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:
20
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
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
20
0
20
0
0
0
Annual IC Time Burden (Hours)
30
0
30
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.