Information Collection

Executive Director questionnaire for ADD Assessment

IC 195747 under ICR 201012-0970-004 · OMB 0970-0372.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ADD Assessment - Executive Director Questionnaire - 10-20-2010.docx	Other-Executive Director questionnai
ADD - web-based survey of Executive Directors.mht	Other-(Executive Director questionna
Appendix A. Email to Executive Directors.docx	Other-Appendix A. Email to Executive

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Executive Director questionnaire for ADD Assessment	ADD Assessment - Executive Director Questionnaire - 10-20-2010.docx	Yes	No	Fillable Printable
Other-(Executive Director questionnaire for ADD Assessment)	ADD - web-based survey of Executive Directors.mht	Yes	No	Fillable Printable
Other-Appendix A. Email to Executive Directors	Appendix A. Email to Executive Directors.docx	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 180

Number of Respondents for Small Entity: 20

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	180	180
Annual IC Time Burden (Hours)	180	180
Annual IC Cost Burden (Dollars)	0	0

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.