Information Collection Request

Intake/Interview & Quality Review Sheets

ICR 201701-1545-009 · OMB 1545-1964 · Historical Active

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Creole French
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Korean
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - (Portuguese)
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Polish
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Vietnamese
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Tagalog
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Chinese Traditional
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Chinese (Simplified)
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet - Arabic
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form ModifiedIntake/Interview & Quality Review Sheet
191233 Intake/Interview & Quality Review Sheet - Spanish Form ModifiedIntake/Interview & Quality Review Sheet - Spanish

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2020 36 Months From Approved 06/30/2017
3,700,000 0 3,700,000
616,803 0 616,803
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Intake/Interview & Quality Review Sheet - Spanish 13614-C (SP)
Intake/Interview and Quality Review Sheet (English & 9 Translations) 13614-C (VN), 13614-C (PT) , 13614-C (KR), 13614-C (HT), 13614-C, 13614-C (AR), 13614-C (CN Simplified), 13614-C (CN Traditional), 13614-C (TL), 13614-C (PL) ,   ,   ,   ,   ,   ,   ,   ,   ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,700,000 3,700,000 0 0 0 0
Annual Time Burden (Hours) 616,803 616,803 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No