Information Collection

Reviewer Recruitment Form

IC 215507 under ICR 201503-0970-001 · OMB 0970-0455.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0455 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Reviewer Recruitment Form	Form and Instruction
1 RRM Profile Questions RRM Profile Questions final 3-3-15.docx	Form and Instruction

IC Title:

Reviewer Recruitment 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
Form and Instruction	1	RRM Profile Questions	RRM Profile Questions final 3-3-15.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	500	500
Annual IC Time Burden (Hours)	125	125
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.