Information Collection

Att K_ Telephone Script

IC 218171 under ICR 201509-0920-002 · OMB 0920-1098.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att J_Telephone Script_15Jan2016.docx	Other-WORD
Att I_Reminder Email.docx Att I_Reminder Email	IC Document

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
Other-WORD			Att J_Telephone Script_15Jan2016.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 119

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	119	119
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att I_Reminder Email	Att I_Reminder Email.docx	09/14/2015

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