View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Scientific Workforce Diversity Seminar Series (SWDSS): Nov 30 Seminar Registration Form (OD)	Agency IC Tracking Number:

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	1	Registration	COSWD FY 2023-2024 SWDSS_Zoom_ Registration Form.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service	FR Citation: 67 FR 60742

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,000	0	1,000	0	0	0
Annual IC Time Burden (Hours)	83	0	83	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Template	0925-0740 Template exp. 9.2025_1_Nov SWDSS Registration Form.docx	11/17/2023
Email/Recruitment Correspondence	Sample Dissemination Language from Previous Seminar.docx	11/17/2023

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