Information Collection

CIS Telephone Clients - Customer Service Questions

IC 43626 under ICR 200907-0925-001 · OMB 0925-0208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0208 can be found here:

Documents and Forms

Document Name Document Type
Form 1 CIS Telephone Clients - Customer Service Questions Form
1 Telephone Client-Customer Service Questions Appendix 2 A Screen Shot Telephone Service Demographic Qs.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CIS Telephone Clients - Customer Service Questions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Telephone Client-Customer Service Questions	Appendix 2 A Screen Shot Telephone Service Demographic Qs.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 62,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	62,000	12,600	49,400
Annual IC Time Burden (Hours)	1,033	-790	1,823
Annual IC Cost Burden (Dollars)	0	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.