Information Collection Request

Intake/Interview & Quality Review Sheets

ICR 202004-1545-016 · OMB 1545-1964 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form 13614-NR Intake/Interview & Quality Review Sheets Form New Available
Form 13614-C Intake/Interview and Quality Review Sheet (English & 9 Translations) Form Modified Repair queued
Form 13614-C (SP) Intake/Interview & Quality Review Sheet - Spanish Form Modified Available
1545-1964 Supporting Statement final 2020_LV.docx Supporting Statement A Uploaded 2020-06-25 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
242421 Intake/Interview & Quality Review Sheets Form New
19697 Intake/Interview and Quality Review Sheet (English & 9 Translations) Form Modified
191233 Intake/Interview & Quality Review Sheet - Spanish Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2022 36 Months From Approved 09/30/2020
3,750,000 0 3,700,000
625,136 0 616,803
0 0 0





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 3,750,000 3,700,000 0 50,000 0 0
Annual Time Burden (Hours) 625,136 616,803 0 8,333 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No