Information Collection

Screening and Recruiting Call

IC 220138 under ICR 201602-0920-009 · OMB 0920-1138.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screening and Recruiting Call	Form and Instruction
Screening and Recruiting Call Attachment C-3_ WHA Screening and Recruiting Call_1-29-16.docx	Form and Instruction

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
Form and Instruction	none	Screening and Recruiting Call	Attachment C-3_ WHA Screening and Recruiting Call_1-29-16.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,684

Number of Respondents for Small Entity: 10,516

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

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	11,684	11,684
Annual IC Time Burden (Hours)	2,921	2,921
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.