Information Collection

Referral Partner Interview Guides

IC 202239 under ICR 201506-0970-017 · OMB 0970-0413.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix J Referral Partners Interview Guides.docx	Other-Referral Partners Interview Gu
Appendix_J_Interview Guides_26APR12.doc Appendix_J_Interview Guides_26APR12	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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-Referral Partners Interview Guides			Appendix J Referral Partners Interview Guides.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	16	16
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix_J_Interview Guides_26APR12	Appendix_J_Interview Guides_26APR12.doc	05/03/2012

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