Information Collection

Live phone follow-up survey

IC 198152 under ICR 201203-0920-004 · OMB 0920-0753.

Documents and Forms

Document Name Document Type
Live phone follow-up survey Form
Live phone follow-up survey Attachment omb.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Live phone follow-up survey	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	none	Live phone follow-up survey	Attachment omb.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,125	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,125	3,125
Annual IC Time Burden (Hours)	365	365
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.