SSA Telephone Interview

Addiction Technology Transfer Centers (ATTC) Network National Workforce Surveys

Documents and Forms

Document Name Document Type
Form Workforce Study SS SSA Telephone Interview Form and Instruction
Workforce Study SS Workforce Study SSA Interview Protocol Attachment 2_ATTC Workforce Study SSA Interview Protocol_12-4-14.docx Form and Instruction
Attachment 4_ATTC Workforce Study Interview Protocol_12-10-14.docx Workforce Study Interview Protocol IC Document

Information Collection (IC) Details

IC Title:	SSA Telephone Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Workforce Study SSA Interview Protocol	Workforce Study SSA Interview Protocol	Attachment 2_ATTC Workforce Study SSA Interview Protocol_12-4-14.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Workforce Study Interview Protocol	Attachment 4_ATTC Workforce Study Interview Protocol_12-10-14.docx	04/15/2015

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