Information Collection

Work Force Recruitment in BPHC-Funded Health Centers Survey

IC 203614 under ICR 201412-0915-001 · OMB 0915-0353.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Work Force Recruitment in BPHC-Funded Health Centers Survey	Form and Instruction
1 workforce survey BPHC 2013 Workforce Recruitment Survey clean.pdf	Form and Instruction
1 non substantive changes BPHC 2014 Workforce Recruitment SurveyNov19TrackChanges.docx	Form

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
Form and Instruction	1	workforce survey	BPHC 2013 Workforce Recruitment Survey clean.pdf		Yes	Yes	Fillable Fileable
Form	1	non substantive changes	BPHC 2014 Workforce Recruitment SurveyNov19TrackChanges.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	2,400	2,400
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.