Early Exit Interview

Evaluation of Public Health AmeriCorps

OMB: 3045-0199

IC ID: 264765

Documents and Forms
Document Name
Document Type
Other-Interview Questions
Other-Interview Questions
Information Collection (IC) Details

View Information Collection (IC)

Early Exit Interview
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Interview Questions 05-Early Exit Interview.docx No   Printable Only

Community and Social Services Social Services

 

10 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10 0 0 0 0 10
Annual IC Time Burden (Hours) 5 0 0 0 0 5
Annual IC Cost Burden (Dollars) 237 0 0 0 0 237

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

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