Information Collection

Frontline staff rosters developed by AIM Team Leads

IC 237393 under ICR 202105-0935-001 · OMB 0935-0246.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form A Frontline staff rosters developed by AIM Team Leads	Form
A Frontline staff rosters developed by AIM Team Leads Attachment A - ROSTER of AIM Team Leads trained in hospitals.docx	Form
A Frontline staff rosters developed by AIM Team Leads Attachment A - ROSTER of AIM Team Leads trained in hospitals.docx	Form

IC Title:

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	A	Frontline staff rosters developed by AIM Team Leads	Attachment A - ROSTER of AIM Team Leads trained in hospitals.docx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 258

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,548	1,548
Annual IC Time Burden (Hours)	124	124
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.