Information Collection

QALICB Representatives Online Survey

IC 192684 under ICR 201004-1559-005 · OMB 1559-0039.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
QALICB Rep On-Line Survey.pdf	Other-On-Line Survey
Burden-Cost Summary.xls Burden-Cost Summary (Aggregated w/Non-Responses)	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
Other-On-Line Survey			QALICB Rep On-Line Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 380

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	145	145
Annual IC Cost Burden (Dollars)	6,943	6,943

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden-Cost Summary (Aggregated w/Non-Responses)	Burden-Cost Summary.xls	05/19/2010

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