The Evaluation of the Smoke Alarm Installation and Fire Safety Education (SAIFE) Program

Documents and Forms

Document Name Document Type
Form 1 The Evaluation of the Smoke Alarm Installation and Fire Safety Education (SAIFE) Program Form
1 Get Alarmed North Carolina! Screener Part 2 Worksheet.Screener_Household_.8-24-09.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	The Evaluation of the Smoke Alarm Installation and Fire Safety Education (SAIFE) Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1	Get Alarmed North Carolina! Screener	Part 2 Worksheet.Screener_Household_.8-24-09.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 425	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	425	-756	1,181
Annual IC Time Burden (Hours)	35	-216	251
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.