Information Collection

Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Health Educators

IC 178809 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form 3 Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Health Educators Form
3 Telephone Verification Sript Final_0920_0255_att3-C_tele_verification_script_rev.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Health Educators	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	3	Telephone Verification Sript	Final_0920_0255_att3-C_tele_verification_script_rev.docx		Yes	Yes	Fillable Printable

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: 420

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	700	700
Annual IC Time Burden (Hours)	117	117
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.