Information Collection

Interviews with PHA staff

IC 195765 under ICR 201108-2528-002 · OMB 2528-0267.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HCV Pretest_Draft Appendix A_12-2-11.doc	Other-Topic Guide for Interviews
HCV Pretest_Draft Appendix A1_1-17-12 guide.doc	Other-Topic Guide for Interviews

IC Title:

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
Other-Topic Guide for Interviews			HCV Pretest_Draft Appendix A_12-2-11.doc		No		Paper Only
Other-Topic Guide for Interviews			HCV Pretest_Draft Appendix A1_1-17-12 guide.doc		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

Number of Respondents for Small Entity: 0

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	Previously Approved
Annual Number of Responses for this IC	8	-52,867	52,875
Annual IC Time Burden (Hours)	192	-758	950
Annual IC Cost Burden (Dollars)	0	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.