Information Collection

Telephone calls with providers of home-based care

IC 187806 under ICR 200901-0970-003 · OMB 0970-0363.

Documents and Forms

Document Name Document Type
#4-Telephone calls with providers of home-based care.doc Other-Telephone calls with providers

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Telephone calls with providers of home-based care	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
Other-Telephone calls with providers of home-based care			#4-Telephone calls with providers of home-based care.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 104	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	104	104
Annual IC Time Burden (Hours)	31	31
Annual IC Cost Burden (Dollars)	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.