Information Collection

HSICC Post Phone Call Survey

IC 232746 under ICR 201801-0970-013 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 HSICC Post Phone Call Survey	Form and Instruction
1 Post Phone Calll Survey Post Phone Call Survey.docx	Form and Instruction
fast-track-PRA-submission-short-form-hsicc (1).doc Justification	IC Document

IC Title:

HSICC Post Phone Call Survey

Agency IC Tracking Number:

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	1	Post Phone Calll Survey	Post Phone Call Survey.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	fast-track-PRA-submission-short-form-hsicc (1).doc	08/20/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.