Information Collection

Recruitment of States

IC 189794 under ICR 200907-0920-001 · OMB 0920-0832.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix_G_-_State_Recruitment_Script[1].doc	Instruction
Appendix G1 - State Letter of Invitation.doc Appendix G1 - State Letter of Invitation	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction					No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17	17
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix G1 - State Letter of Invitation		06/16/2009

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

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