Information Collection

Invitation

IC 234078 under ICR 201811-0910-002 · OMB 0910-0867.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 5 Telephone Scripts.docx	Other-Telephone Script
Appendix 6 Survey Materials.docx	Other-Survey Materials

IC Title:

Invitation

Agency IC Tracking Number:

CFSAN

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
Other-Telephone Script			Appendix 5 Telephone Scripts.docx		Yes	No	Paper Only
Other-Survey Materials			Appendix 6 Survey Materials.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 898

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 65 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	898	898
Annual IC Time Burden (Hours)	72	72
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.