View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

State Program Improvement Technical Assistance Event Satisfaction
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction TA Onsite_Offsite_initial and follow up feedback TA Onsite_Offsite_initial and follow up feedback TA Onsite_Offsite_initial and follow up feedback_final 4-17-23.docx Yes Yes Fillable Fileable
Form and Instruction LC Individual Session Feedback Form LC Individual Session Feedback Form LC Individual Session Feedback Form_final 4-17-23.docx Yes Yes Fillable Fileable
Form and Instruction LC Overall Series Feedback Form LC Overall Series Feedback Form LC Overall Series Feedback Form_final 4-17-23.docx Yes Yes Fillable Fileable
Form and Instruction LC Customer Feedback Form LC Customer Feedback Form LC Customer Feedback Form - Follow up_final 4-17-23.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Privacy Act of 1974 (Title 5 United States Code [U.S.C.] 552a)  75 FR 28264

1,034 0
   
State, Local, and Tribal Governments
 
   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 1,034 0 1,034 0 0 0
Annual IC Time Burden (Hours) 153 0 153 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Transmittal email State TA_ Transmittal email State TA_.docx 05/10/2023
State TA 0930-0393 Fast Track Generic Submission _5-4-23 State TA 0930-0393 Fast Track Generic _5-4-23.docx 05/10/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.