Information Collection

NHBS Recruiter Debriefing

IC 196956 under ICR 201909-0920-001 · OMB 0920-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0770 NHBS Recruiter Debriefing	Form and Instruction
0920-0770 Recruiter Debriefing (English) Att 3e_Recruiter_Debriefing_Eng.pdf	Form and Instruction
0920-0770 Recruiter Debriefing (Spanish) Att 4e_Recruiter_Debriefing_Spanish.pdf	Form and Instruction
Att 15_Recruiter training script.docx Recruiter Training Script	IC Document

IC Title:

NHBS Recruiter Debriefing

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	0920-0770	Recruiter Debriefing (English)	Att 3e_Recruiter_Debriefing_Eng.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0770	Recruiter Debriefing (Spanish)	Att 4e_Recruiter_Debriefing_Spanish.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,167

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	Previously Approved
Annual Number of Responses for this IC	4,167	333	3,834
Annual IC Time Burden (Hours)	139	11	128
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Recruiter Training Script	Att 15_Recruiter training script.docx	09/27/2019

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