Information Collection

Referral Partner Interview Guides

IC 202239 under ICR 201305-0970-006 · OMB 0970-0413.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0413 can be found here:

Documents and Forms

Document Name Document Type
Appendix J Referral Partners Interview Guides.docx Other-Referral Partners Interview Gu
Appendix_J_Interview Guides_26APR12.doc Appendix_J_Interview Guides_26APR12 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Referral Partner Interview Guides	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
Other-Referral Partners Interview Guides			Appendix J Referral Partners Interview Guides.docx		Yes	Yes	Fillable Fileable

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: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix_J_Interview Guides_26APR12	Appendix_J_Interview Guides_26APR12.doc	05/03/2012

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