Information Collection

Town Hall Meetings Feedback Form

IC 182093 under ICR 200709-0930-004 · OMB 0930-0288.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0288 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment 1 - For Town Hall Meetings Feedback Form Form and Instruction
Attachment 1 - For Attachment 1 - Form Attachment 1 THM OMB 2007.doc Form and Instruction
Attachment 2 THM OMB 2007.doc Attachment 2 - Comments IC Document
Attachment 3 THM OMB 2997.doc Attachment 3 - CBO Verification Letter IC Document
Attachment 4 THM OMB 2007.doc Attachment 4 - Initial Mailing Letter IC Document
Attachment 5 THM OMB 2007.doc Attachment 5 - Follow-up Mailing Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Town Hall Meetings Feedback Form	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
Form and Instruction	Attachment 1 - Form	Attachment 1 - Form	Attachment 1 THM OMB 2007.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 2 - Comments	Attachment 2 THM OMB 2007.doc	09/06/2007
Attachment 3 - CBO Verification Letter	Attachment 3 THM OMB 2997.doc	09/06/2007
Attachment 4 - Initial Mailing Letter	Attachment 4 THM OMB 2007.doc	09/06/2007
Attachment 5 - Follow-up Mailing Letter	Attachment 5 THM OMB 2007.doc	09/06/2007

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