Information Collection

Collection of Data for Program Evaluation

IC 44712 under ICR 200608-2139-001 · OMB 2139-0011.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BTS-0602 Collection of Data for Program Evaluation	Form and Instruction
BTS-0602 C3RS Evaluation survey - supervisor version Supervisor version 9-14-06.doc	Form and Instruction
BTS-0603 C3RS Evaluation Survey - worker version Worker version 9-14-06.doc	Form and Instruction
FRNotice for Eval.pdf 60-day FR Notice	IC Document
ClaoeCallevaluationNotice.pdf 30-day FR Notice	IC Document
SafetealuSec5601.doc SAFETEALU	IC Document
CIPSEA.pdf CIPSEA	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BTS-0602	C3RS Evaluation survey - supervisor version	Supervisor version 9-14-06.doc		Yes	No	Paper Only
Form and Instruction	BTS-0603	C3RS Evaluation Survey - worker version	Worker version 9-14-06.doc		Yes	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	10,176	10,176

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
60-day FR Notice	FRNotice for Eval.pdf	08/15/2006
30-day FR Notice	ClaoeCallevaluationNotice.pdf	08/15/2006
SAFETEALU	SafetealuSec5601.doc	08/15/2006
CIPSEA	CIPSEA.pdf	08/29/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.