Information Collection

Other Key Staff Telephone Script to schedule site visit

IC 218980 under ICR 201511-0925-003 · OMB 0925-0734.

Documents and Forms

Document Name Document Type
Form 11 Other Key Staff Telephone Script to schedule site visit Form and Instruction
11 Attachment 27 Telephone Script to Schedule the Site Visi Attachment 27. Telephone Script to Schedule the Site Visit Interview.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Other Key Staff Telephone Script to schedule site visit	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	11	Attachment 27 Telephone Script to Schedule the Site Visit Interview	Attachment 27. Telephone Script to Schedule the Site Visit Interview.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	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	90	90
Annual IC Time Burden (Hours)	8	8
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.