OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire

IC 3428 under ICR 200906-0607-003 · OMB 0607-0404.

Documents and Forms
Document Name
Document Type
Other-Proposed Changes to BC-1294
Other-Proposed Changes to BC-1294(D)
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire
 
No Modified
 
Voluntary
 

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.doc No   Paper Only
Form BC-1294(D) Decennial Field Staff Exit Questionnaire bc1294d.pdf No   Paper Only
Other-Proposed Changes to BC-1294(D) BC1294D changes.doc No   Paper Only
Form BC-1294(CM) Coverage Measurement Exit Questionnaire bc1294ccm.pdf No   Paper Only
Form BC-1294 Field Representative Exit Questionnaire bc1294.pdf No   Paper Only

General Government Central Records & Statistical Mgt

 

2,500 0
   
Individuals or Households
 
   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 2,500 0 0 0 0 2,500
Annual IC Time Burden (Hours) 393 0 0 0 0 393
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.