Information Collection

NHBS Recruiter Debriefing

IC 196956 under ICR 202010-0920-017 · 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⚠️ Notice: This information collection may be referencing outdated material.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: Unchanged

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	Previously Approved
Annual Number of Responses for this IC	4,167	4,167
Annual IC Time Burden (Hours)	139	139
Annual IC Cost Burden (Dollars)	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.