Information Collection

COVID Screener Questions and Appointment Check-In - Telephone Check-In

IC 254133 under ICR 202206-0960-005 · OMB 0960-0824.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Express Interviews Pre-Screening Questions.pdf	Other-Telephone Script
Express Interviews Pre-Screening Questions.pdf	Other-Telephone Script

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 422.103 - 422.110

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
Other-Telephone Script			Express Interviews Pre-Screening Questions.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 661,554

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	661,554	661,554
Annual IC Time Burden (Hours)	441,036	441,036
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.