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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Natinal Public Health Improvement Initiative: Program Assessment
Agency IC Tracking Number:
14ARI
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
Other-WORD
Att D_Interviewee Request Form.docx
Yes
Yes
Fillable Printable
Other-WORD
Att F_Interview Guide.docx
No
Fillable Printable
Other-PDF
Att E_Screenshots of Interviewee Request Form.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
63
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
33 %
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
63
0
63
0
0
0
Annual IC Time Burden (Hours)
46
0
46
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SupSta A
NPHII-QUAL-SSA.DOCX
07/24/2014
Sup Sta B
NPHII-QUAL-SSB.DOCX
07/24/2014
Att A - Listring of NPHII Awardees
Att A_NPHII Awardees.docx
07/24/2014
Att B_NPHII: Mid-Program Evaluation Report
Att B_Mid-Program Report Executive Summary.pdf
07/24/2014
Att C - NPHII: Summative Assessment Qs & D Sources
Att C_NPHII Summative Assessment Questions and Data Sources.docx
07/24/2014
Att G_Adv Notification Email
Att G_Advance Notification Email.docx
07/24/2014
Att H_ Interview Inv Email
Att H_Interview Invitation Email.docx
07/24/2014
Att I_Interview Conf Email
Att I_Interview Confirmation Email.docx
07/24/2014
Att J_Participant Reminder Email
Att J_Participant Reminder Email.docx
07/24/2014
Att K_F/U Inv Email
Att K_Follow-up Invitation Email.docx
07/24/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.