Information Collection

NEARS Manager Interview

IC 221097 under ICR 201905-0920-008 · OMB 0920-0980.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0980 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0980 NEARS Manager Interview	Form and Instruction
0920-0980 Manager Interview Att8_Manager Interview 5-14.docx	Form and Instruction

IC Title:

NEARS Manager Interview

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	0920-0980	Manager Interview	Att8_Manager Interview 5-14.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,200	200	1,000
Annual IC Time Burden (Hours)	400	67	333
Annual IC Cost Burden (Dollars)	0	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.