Information Collection

Recruitment for State Surveys of Endoscopic Capacity

IC 193168 under ICR 201006-0920-003 · OMB 0920-0539.

Documents and Forms

Document Name Document Type
0539_Att F2_STATE TELEPHONE SCRIPT.doc Other-WORD
0539_Att G2_ Reminder Call Script.doc 0539_Att G2_ Reminder Call Script IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Recruitment for State Surveys of Endoscopic Capacity	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-WORD			0539_Att F2_STATE TELEPHONE SCRIPT.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0539_Att G2_ Reminder Call Script	0539_Att G2_ Reminder Call Script.doc	05/11/2010

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