Information Collection

Project Director - Telephone Follow-up

IC 208305 under ICR 201308-0930-002 · OMB 0930-0339.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0339 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form PD Interview Project Director - Telephone Follow-up	Form and Instruction
PD Interview PD Interview Attachment 01_PD Interview.docx	Form and Instruction
Attachment 05_PD Interview_Consent and Script.docx PD Interview_Consent and Script	IC Document
Attachment 10_Analysis Table Shells.docx Analysis Table Shells	IC Document

IC Title:

Project Director - Telephone Follow-up

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	PD Interview	PD Interview	Attachment 01_PD Interview.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 158

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	158	158
Annual IC Time Burden (Hours)	332	332
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PD Interview_Consent and Script	Attachment 05_PD Interview_Consent and Script.docx	08/19/2013
Analysis Table Shells	Attachment 10_Analysis Table Shells.docx	08/19/2013

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