View Information Collection (IC)

View Information Collection (IC)

IC Title:	NHBS Recruiter Debriefing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0920-0770	Attachment 2e Recruiter Debriefing English version	0920-0770_Att 2e_Recruiter_Debrief_Eng.pdf		Yes	Yes	Fillable Printable
Form and Instruction	0920-0770	Attachment 3e Recruiter Debrief Spanish version	0920-0770_Att 3e_Recruiter_Debrief_Spanish.pdf		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

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 %

	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	4,167	0	0	0	0	4,167
Annual IC Time Burden (Hours)	139	0	0	0	0	139
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 15 Recruiter Training Script	0920-0770_Att 15_Recruiter Training Script.pdf	03/08/2011

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