FOUR-MONTH FOLLOW UP EVALUATION FORM

ICR 198201-3136-004

OMB: 3136-0044

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
155052
Migrated
ICR Details
3136-0044 198201-3136-004
Historical Active
NEH
FOUR-MONTH FOLLOW UP EVALUATION FORM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/15/1982
Retrieve Notice of Action (NOA) 01/22/1982
  Inventory as of this Action Requested Previously Approved
06/30/1982 06/30/1982
38 0 0
76 0 0
0 0 0

THE FORMS WILL BE USED (A) TO FOLLOW UP ON POST-WORKSHOP PROGRESS (B) TO HELP PARTICIPANTS REMAIN IN CONTACT WITH EACH OTHER'S WORK-IN PROGRESS (C) TO REPORT TO SPONSORING AGENCY UNDER CONTRACT NEH-C-80 14 AND UNDER OMB CIRCULAR A110 ATTACHMENT H.

None
None


No

1
IC Title Form No. Form Name
FOUR-MONTH FOLLOW UP EVALUATION FORM

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 38 0 0 38 0 0
Annual Time Burden (Hours) 76 0 0 76 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/22/1982


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