Information Collection

NEARS Manager Interview

IC 221097 under ICR 202601-0920-006 · OMB 0920-0980.

Documents and Forms

Document Name Document Type
NEARS Manager Interview Form and Instruction
Manager Interview Att7 NEARS Manager Interview Recording Form 11-25.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NEARS Manager Interview	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	n/a				Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 46	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,104	-128	1,232
Annual IC Time Burden (Hours)	368	-43	411
Annual IC Cost Burden (Dollars)	0	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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