Information Collection

Telephone Script To Schedule Telephone Interview

IC 213452 under ICR 201410-0925-001 · OMB 0925-0707.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0707 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 TELEPHONE SCRIPT TO SCHEDULE TELEPHONE INTERVIEW	Form
4 TELEPHONE SCRIPT TO SCHEDULE TELEPHONE INTERVIEW Attachment 27.Telephone Script to Schedule Interview.9-2-14.docx	Form

IC Title:

TELEPHONE SCRIPT TO SCHEDULE TELEPHONE INTERVIEW

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	4	TELEPHONE SCRIPT TO SCHEDULE TELEPHONE INTERVIEW	Attachment 27.Telephone Script to Schedule Interview.9-2-14.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6	6
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	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.