OMB
.report
Search
Key Informant Interview Evaluator
[NCIPC] DELTA Achieving Health Equity through Addressing Disparities (AHEAD) COOPERATIVE AGREEMENT EVALUATION
OMB: 0920-1412
IC ID: 260625
OMB.report
HHS/CDC
OMB 0920-1412
ICR 202305-0920-013
IC 260625
( )
Documents and Forms
Document Name
Document Type
Form 0920-23AA
Key Informant Interview Evaluator
Form and Instruction
0920-23AA Att. 4b Key Informant Interview Protocol - Evaluator
Att. 4b Key Informant Interview Protocol - Evaluator.pdf
Form and Instruction
0920-23AA Att. 4b Key Informant Interview Protocol - Evaluator
Att. 4b Key Informant Interview Protocol - Evaluator.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Key Informant Interview Evaluator
Agency IC Tracking Number:
0920-23AA
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
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
0920-23AA
Att. 4b Key Informant Interview Protocol - Evaluator
Att. 4b Key Informant Interview Protocol - Evaluator.pdf
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:
13
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
13
0
13
0
0
0
Annual IC Time Burden (Hours)
13
0
13
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.