Information Collection

Key Staff Selected Treatment Organization Telephone Interview

IC 216133 under ICR 201504-0930-001 · OMB 0930-0351.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Workforce Study Ke Key Staff Selected Treatment Organization Telephone Interview	Form and Instruction
Workforce Study Ke Workforce Study Key Staff Telephone Interview Attachment 3_ATTC Workforce Study Key Staff at Selected Treatment Organization Interview Protocol_12-22-14.docx	Form and Instruction

IC Title:

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	Workforce Study Key Staff Telephone Interview	Workforce Study Key Staff Telephone Interview	Attachment 3_ATTC Workforce Study Key Staff at Selected Treatment Organization Interview Protocol_12-22-14.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 %

table that charts list of burden
	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

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.