Information Collection

Key Informant Interview

IC 199730 under ICR 201110-0920-003 · OMB 0920-0908.

Documents and Forms

Document Name Document Type
REVISED_Attachment 5_KeyInformantInterview_Nov 10 2011 Version.doc Instruction
Attch9ConsentScriptKeyInformant.docx Key Informant Consent Script IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Key Informant Interview	Agency IC Tracking Number:

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
Instruction			REVISED_Attachment 5_KeyInformantInterview_Nov 10 2011 Version.doc		No		Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	32	32
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Key Informant Consent Script	Attch9ConsentScriptKeyInformant.docx	10/06/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.