Survey of Co-Sponsors

Evaluation of the Action Plan for the National Public Health Initiative on Diabetes and Womens Health

Documents and Forms

Document Name Document Type
Form 1 Survey of Co-Sponsors Form and Instruction
1 Survey of Co-Sponsors Attachment E Co-Sponsor Survey.doc Form and Instruction
Attachment E1 Cosponsor Invitation.doc Attachment E1 Cosponsor Invitation IC Document
Attachment E2 Cosponsor Reminder.doc Attachment E2 Cosponsor Reminder IC Document

Information Collection (IC) Details

IC Title:	Survey of Co-Sponsors	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	1	Survey of Co-Sponsors	Attachment E Co-Sponsor Survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment E1 Cosponsor Invitation	Attachment E1 Cosponsor Invitation.doc	11/12/2009
Attachment E2 Cosponsor Reminder	Attachment E2 Cosponsor Reminder.doc	11/12/2009

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