Information Collection

Midwest Event Evaluation

IC 204261 under ICR 201209-0920-008 · OMB 0920-0954.

Documents and Forms

Document Name Document Type
Midwest Event Evaluation Form
Midwest Event Evaluation F3_Midwest FASD Regional Training Center Event Evaluation.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Midwest Event Evaluation	Agency IC Tracking Number:

Is this a Common Form? No		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	none	Midwest Event Evaluation	F3_Midwest FASD Regional Training Center Event Evaluation.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,110	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,110	1,110
Annual IC Time Burden (Hours)	93	93
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.