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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Interview Planning Tool
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
Form
none
Interview Planning Tool
Attachment 7a Interview Planning Tool.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
24
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
24
0
24
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 7c - FAQ
Attachment 7c Case Study FAQs for CPPW-Affordable Care Act Sites.doc
10/22/2010
Att 7b - Introductory Letter
Attachment 7b CPPW Case Study Introductory Letter.doc
10/22/2010
Att 7d - Introductory Email
Attachment 7d Introductory e-mail to schedule site visit preparatory call.doc
10/22/2010
Att 7e - Script for Preparatory Call
Attachment 7e Site Visit Preparatory Call.doc
10/22/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.