Information Collection

Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Social and Community Service Managers

IC 178808 under ICR 201011-0920-008 · OMB 0920-0255.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0255 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Social and Community Service Managers	Form
3 Telephone Verification Script Final_0920_0255_att3-C_tele_verification_script_rev.docx	Form

IC Title:

Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Social and Community Service Managers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form	3	Telephone Verification Script	Final_0920_0255_att3-C_tele_verification_script_rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 700

Number of Respondents for Small Entity: 400

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	117	117
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.