Information Collection

Recruitment of States

IC 189795 under ICR 200907-0920-001 · OMB 0920-0832.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix_H_-_District_Recruitment_Script[1].doc	Instruction
Appendix H1 - District Letter of Invitation.doc Appendix H1 - District 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			Appendix_H_-_District_Recruitment_Script[1].doc		No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

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	80	80
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix H1 - District Letter of Invitation	Appendix H1 - District Letter of Invitation.doc	06/16/2009

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