Three Month Telephone

Federal Strategic Action Plan on Services for Victims of Human Trafficking: Enhancing the Health Care System's Response

Documents and Forms

Document Name Document Type
Form 1 Three Month Telephone Form and Instruction
1 Three Month Follow-up Phone Call 3 Month Follow-up Phone Call 7.24.14.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Three Month Telephone	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	1	Three Month Follow-up Phone Call	3 Month Follow-up Phone Call 7.24.14.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	24	24
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.