SA/LA - User Response, Feedback, and Request Forms

Generic Clearance to Conduct Formative Research

OMB: 0584-0524

IC ID: 183162

Documents and Forms
Document Name
Document Type
Other-User Response
Other-Commitment Form
Other-Request-Agreement
Other-Feedback
Other-Feedback
Other-Feedback
Other-Response
Other-Response
Information Collection (IC) Details

View Information Collection (IC)

SA/LA - User Response, Feedback, and Request Forms
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-User Response ATTH 1 User Response Form-Educators' Web Site.doc Yes Yes Fillable Fileable
Other-Commitment Form ATTH 4 Power Panther Commitment Form.doc Yes Yes Fillable Fileable
Other-Request-Agreement ATTH 5 Power Panther Costume Request & Agreement.doc Yes Yes Fillable Fileable
Other-Feedback ATTH 6 Power Panther Costume Feedback.pdf Yes Yes Fillable Fileable
Other-Feedback ATTH 7 Take Action-Breastfeeding Web Resource Feedback.doc Yes Yes Fillable Fileable
Other-Feedback ATTH 8 Take Action-Fruits Veg Web Resource Feedback.doc Yes Yes Fillable Fileable
Other-Response ATTH 9 Loving Your Family User Response Card.pdf Yes No Paper Only
Other-Response ATTH 10 Activity Kit User Response Form.doc Yes Yes Fillable Fileable

Health Public Health Monitoring

 

2,200 0
   
Federal Government
 
   99 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,200 0 0 0 0 0
Annual IC Time Burden (Hours) 367 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
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