Information Collection

Site Staff and Community Partners (Telephone Interview)

IC 190917 under ICR 200910-0990-001 · OMB 0990-0356.

Documents and Forms

Document Name Document Type
Attachment C Telephone Interview_Post Pretest Advisory Revisions 9 10 09.docx Other-survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Site Staff and Community Partners (Telephone Interview)	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-survey			Attachment C Telephone Interview_Post Pretest Advisory Revisions 9 10 09.docx		Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	72	72
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.