Information Collection

IDRWG Trainee Survey

IC 192704 under ICR 201004-0925-001 · OMB 0925-0615.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 IDRWG Trainee Survey	Form
1 IDRWG Trainee Survey Attachment 2 IDRWG Trainee SURVEY.doc	Form
Attachement 3 Email invitations 3.23.10.doc Attachement 3 Email invitations 3	IC Document

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
Form	1	IDRWG Trainee Survey	Attachment 2 IDRWG Trainee SURVEY.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	3,450	3,450

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachement 3 Email invitations 3	Attachement 3 Email invitations 3.23.10.doc	03/24/2010

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