Information Collection

PI Telephone interview

IC 218955 under ICR 201511-0925-003 · OMB 0925-0734.

Documents and Forms

Document Name Document Type
Form 3 PI Telephone interview Form and Instruction
3 Attachment 3 PI interview Protocol Attachment 3. PI Interview Protocol.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	PI 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	3	Attachment 3 PI interview Protocol	Attachment 3. PI Interview Protocol.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	34	34
Annual IC Time Burden (Hours)	34	34
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.