PRC Telephone Interview

Prevention Research Centers Program National Evaluation Reporting System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0650 can be found here:

Documents and Forms

Document Name Document Type
PRC Telephone Interview Form
Telephone Interview Attachment 5. Telephone Interview.doc Form

Information Collection (IC) Details

IC Title:	PRC Telephone Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Telephone Interview	Attachment 5. Telephone Interview.doc		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 37	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	37	37
Annual IC Time Burden (Hours)	37	37
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.