Telephone Interview with VR Agency Staff

Evaluation of the Helen Keller National Center for Deaf-Blind Youths and Adults

Documents and Forms

Document Name Document Type
Telephone Interview with VR Agency Staff Form and Instruction
Telephone Interview VR Agency Staff Att_Telephone Interview VR Agency Staff 08-09.doc Form and Instruction
Att_Telephone Interview VR Agency Staff 08-09.doc Letter of assurances IC Document

Information Collection (IC) Details

IC Title:	Telephone Interview with VR Agency Staff	Agency IC Tracking Number:	4157

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	N/A	Telephone Interview VR Agency Staff	Att_Telephone Interview VR Agency Staff 08-09.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 40 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Letter of assurances	Att_Telephone Interview VR Agency Staff 08-09.doc	12/29/2009

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