Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire Modified 2500 393 0 Other-Proposed Changes to BC-1294
Form BC-1294(D) Decennial Field Staff Exit Questionnaire
Other-Proposed Changes to BC-1294(D)
Form BC-1294(CM) Coverage Measurement Exit Questionnaire
Form BC-1294 Field Representative Exit Questionnaire
Total burden requested under this ICR: 2500 393 0  
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