Information Collection

NHBS Recruiter Debriefing

IC 196956 under ICR 202603-0920-004 · OMB 0920-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0770 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-26-0109 Recruiter_Debriefing_English NHBS Recruiter Debriefing Form
Form 0920-26-0109 Recruiter_Debriefing_Spanish NHBS Recruiter Debriefing Form
0920-26-0109 Recruiter_Debriefing_English Att 3e_Recruiter_Debriefing_Eng.docx Form
0920-26-0109 Recruiter_Debriefing_Spanish Att 4e_Recruiter_Debriefing_Spanish.docx Form
Att 15_Recruiter training script.docx Recruiter Training Script IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NHBS Recruiter Debriefing	Agency IC Tracking Number:	0920-26-0109

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	0920-26-0109	Recruiter_Debriefing_English	Att 3e_Recruiter_Debriefing_Eng.docx		Yes	Yes	Fillable Fileable
Form	0920-26-0109	Recruiter_Debriefing_Spanish	Att 4e_Recruiter_Debriefing_Spanish.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,500	167	3,333
Annual IC Time Burden (Hours)	117	5	112
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Recruiter Training Script	Att 15_Recruiter training script.docx	09/27/2019

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].