Information Collection

Interview Assessment Form

IC 214707 under ICR 201501-0420-001 · OMB 0420-0556.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0420-0556 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Interview Assessment Form_PCR_FINAL.docx	Other-Questions

IC Title:

Interview Assessment Form

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
Other-Questions			Interview Assessment Form_PCR_FINAL.docx		No		Paper Only

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	700	700
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.