Information Collection

WIRED Initiative Evaluation, screener, local governments

IC 188329 under ICR 200901-1205-003 · OMB 1205-0475.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
WIRED Screener Survey 6 25 09.doc	Other-survey

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
Other-survey			WIRED Screener Survey 6 25 09.doc		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,040

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,040	1,040
Annual IC Time Burden (Hours)	87	87
Annual IC Cost Burden (Dollars)	3,120	3,120

Documents for IC

table that charts IC Documents
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.