Information Collection

Follow-up III Telephone Prompting Script

IC 220199 under ICR 201602-0925-013 · OMB 0925-0522.

Documents and Forms

Document Name Document Type
Form 3 Follow-up III Telephone Prompting Script Form and Instruction
3 Follow-Up Phone script SISOMB2016ATTACHMENT2cFOLLOWUPscript20160219REVISED.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Follow-up III Telephone Prompting Script	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	Follow-Up Phone script	SISOMB2016ATTACHMENT2cFOLLOWUPscript20160219REVISED.pdf		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,832	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	4,832	4,832
Annual IC Time Burden (Hours)	242	242
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.