Information Collection

"Talk. They Hear You." Community Partner License Survey

IC 279383 under ICR 202603-0930-001 · OMB 0930-0316.

Documents and Forms

Document Name Document Type
Form Talk.TheyHear You. Talk.TheyHear You.Community Partner License Survey "Talk. They Hear You." Community Partner License Survey Form and Instruction
Talk.TheyHear You. Talk.TheyHear You.Community Partner License Survey “Talk. They Hear You.” Community Partner License Survey_final.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	"Talk. They Hear You." Community Partner License Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Talk.TheyHear You.Community Partner License Survey	Talk.TheyHear You.Community Partner License Survey	âTalk. They Hear You.â Community Partner License Survey_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Privacy Act of 1974	FR Citation: 75 FR 28264

Number of Respondents: 260	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	260	260
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.

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