Information Collection

Recruitment telephone Script

IC 194320 under ICR 201008-0920-010 · OMB 0920-0871.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
att5c_RecruitPhoneScript_ENG.doc	Instruction
att5e_RecruitPhoneScript_SPA.doc	Instruction
att5b_RecruitLetter_ENG.doc Attachment 5b Recruitment Letter	IC Document
att5a_Recruitment Flyer.doc Attachment 5a Recruitment Flyer	IC Document
att5d_RecruitLetter_SPA.doc Attachment 5d Recruitment Letter Spanish	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			att5c_RecruitPhoneScript_ENG.doc		Yes	Yes	Printable Only
Instruction			att5e_RecruitPhoneScript_SPA.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 5b Recruitment Letter	att5b_RecruitLetter_ENG.doc	07/23/2010
Attachment 5a Recruitment Flyer	att5a_Recruitment Flyer.doc	07/23/2010
Attachment 5d Recruitment Letter Spanish	att5d_RecruitLetter_SPA.doc	07/23/2010

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