Information Collection

Baseline survey and consent – program participants

IC 243182 under ICR 202008-1290-001 · OMB 1290-0034.

Documents and Forms

Document Name Document Type
Attachment A - Baseline Survey and Consent Form for Program Participants.docx Other-Baseline Survey and Consent

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Baseline survey and consent â program participants	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-Baseline Survey and Consent			Attachment A - Baseline Survey and Consent Form for Program Participants.docx		No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	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	5,000	5,000
Annual IC Time Burden (Hours)	1,667	1,667
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.