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Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer
[NCIPC] Reporting of the Essentials for Childhood (EfC): Preventing Adverse Childhood Experiences through Data to Action Program
OMB: 0920-1425
IC ID: 262775
OMB.report
HHS/CDC
OMB 0920-1425
ICR 202310-0920-004
IC 262775
( )
Documents and Forms
Document Name
Document Type
Form 0920
Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer
Form and Instruction
0920 Instrument and Protocol Key Informant Interview - Princi
Att. 4b Key Informant Interview - Principal InvestigatorImplementor (KII).docx
Form and Instruction
0920 Instrument and Protocol Key Informant Interview - Princi
Att. 4b Key Informant Interview - Principal InvestigatorImplementor (KII).docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Instrument and Protocol Key Informant Interview - Principal Investigators/Implementer
Agency IC Tracking Number:
0920-23DT
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
Instrument and Protocol Key Informant Interview - Principal Investigators
Att. 4b Key Informant Interview - Principal InvestigatorImplementor (KII).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:
12
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
12
0
12
0
0
0
Annual IC Time Burden (Hours)
12
0
12
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.