View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Web Survey Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.6

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: Our Town Evaluation Web Survey Instrument	FR Citation: 83 FR 16402

Number of Respondents: 381	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	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	381	0	381	0	0	0
Annual IC Time Burden (Hours)	191	0	191	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Communications Material		10/15/2018
Cognitive Testing Report		10/15/2018
Final Study Plan		10/15/2018

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

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