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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Formative Evaluation of Professional Development Resources - Web Survey
Agency IC Tracking Number:
0920-0840-19ANZ
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 and Instruction
0920-0840
Formative Evaluation of Professional Development Resources - Web Survey
Att 3a_Screen Shots of Survey.pdf
Yes
Yes
Fillable Fileable
Other-WORD
Att 3_Survey.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
475
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
475
0
475
0
0
0
Annual IC Time Burden (Hours)
174
0
174
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement A
SS A.doc
04/24/2019
Supporting Statement B
SS B.docx
04/24/2019
Att 1_ Authorizing Leg
Att 1_Auth Legislation.doc
04/24/2019
Att 2_60dy FRN
Att 2_60 Day FRN.pdf
04/24/2019
Att 4_Consultant
Att 4_Consultants.docx
04/24/2019
Att 5_ Informed Consent
Att 5_Informed Consent.docx
04/24/2019
Att 6_Email Invite_Reminder
Att 6_Email Invite_Reminder Email.docx
04/24/2019
Att 7_ICF IRB
Att 7_ICF IRB Exempt Approval Documents 2-11-19.pdf
04/24/2019
Att 8_Respondent Universe
Att 8_Respondent Universe.docx
04/24/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.