View Information Collection (IC)

View Information Collection (IC)

IC Title:	Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire	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
Other-Proposed Changes to BC-1294			BC1294 Changes 12-2011.doc		No		Paper Only
Form	BC-1294(D)	Decennial Field Staff Exit Questionnaire	BC-1294(D) (05-06-09).pdf		No		Paper Only
Form	BC-1294	Field Representative Exit Questionnaire	bc1294 (9-14-09).pdf		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 650	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	650	0	0	-1,850	0	2,500
Annual IC Time Burden (Hours)	84	0	0	-309	0	393
Annual IC Cost Burden (Dollars)	0	0	0	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.