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1-4 Year Resident Physician
Evaluation of the Afghanistan Health Initiative Project
OMB: 0990-0332
IC ID: 185755
OMB.report
HHS/HHSDM
OMB 0990-0332
ICR 200807-0990-001
IC 185755
( )
Documents and Forms
Document Name
Document Type
Form 0990
1-4 Year Resident Physician
Form
0990 Clinician Interview Guide
0990-Evaluation of AfghanistanAppendix E - Clinician Interview Guide_with cover June25.doc
Form
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
1-4 Year Resident Physician
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
0990
Clinician Interview Guide
0990-Evaluation of AfghanistanAppendix E - Clinician Interview Guide_with cover June25.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
11
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
11
0
11
0
0
0
Annual IC Time Burden (Hours)
9
0
9
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc
07/10/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.