Information Collection

Interviewer Administrative Forms (Attachment 9)

IC 201514 under ICR 201510-0925-005 · OMB 0925-0654.

Documents and Forms

Document Name Document Type
Form 9 Interviewer Administrative Forms (Attachment 9) Form and Instruction
9 Administrative forms for the Interviewer Attach 9 -_Admin_forms_interviewers_REV_07_02_12.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Interviewer Administrative Forms (Attachment 9)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	9	Administrative forms for the Interviewer	Attach 9 -_Admin_forms_interviewers_REV_07_02_12.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 19	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,204	2,204
Annual IC Time Burden (Hours)	-1,102	1,102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.