Information Collection

Revised Draft Pre-Test

IC 209170 under ICR 201307-3084-004 · OMB 3084-0161.

Documents and Forms

Document Name Document Type
Revised Draft Pre-Test 11-1-13.pdf Other-Pretest
Revised Draft Questionnaire 11-1-13.pdf Other-Questionnaire

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Revised Draft Pre-Test	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
Other-Pretest			Revised Draft Pre-Test 11-1-13.pdf		Yes	Yes	Fillable Fileable
Other-Questionnaire			Revised Draft Questionnaire 11-1-13.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	58	58
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.