Information Collection

Yellowstone National Park Backcountry Survey [Web-based Version]

IC 180717 under ICR 200706-0920-011 · OMB 0920-0727.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Yellowstone National Park Backcountry Survey [Web-based Version]	Form and Instruction
Yellowstone National Park Backcountry Survey Appendix M_Yellowstone Study Questionnaire - Internet Version_060707.doc	Form and Instruction
Appendix K_Yellowstone Study Introductory Email_060607.doc Introductory E-mail	IC Document
Appendix L_Yellowstone Study Consent - Internet Version_060707.doc Yellowstone Study Consent	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	None	Yellowstone National Park Backcountry Survey	Appendix M_Yellowstone Study Questionnaire - Internet Version_060707.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 0920-0136, Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 3,423

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,423	3,423
Annual IC Time Burden (Hours)	1,712	1,712
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Introductory E-mail	Appendix K_Yellowstone Study Introductory Email_060607.doc	06/13/2007
Yellowstone Study Consent	Appendix L_Yellowstone Study Consent - Internet Version_060707.doc	06/13/2007

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