Information Collection

Evaluation of Facilitation Services (Participant) - IC for State, Local and Tribal Govt. Respondents

IC 185877 under ICR 201012-3320-002 · OMB 3320-0010.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3320-000N(1) Evaluation of Facilitation Services (Participant) - IC for State, Local and Tribal Govt. Respondents	Form and Instruction
3320-000N(1) Facilitation Services - Participant Questionnaire (Rev 2 Facilitation Services Participant Questionnaire (Rev2011).pdf	Form and Instruction
3320-000N(1) Facilitation Services - Participant Questionnaire Rev 20 Facilitation Services Participant Questionnaire _Rev2012_.pdf Note; Currently being completed	Form and Instruction

IC Title:

Agency IC Tracking Number:

000Nb

Is this a Common Form? No

IC Status: Modified

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 and Instruction	3320-000N(1)	Facilitation Services - Participant Questionnaire (Rev 2011)	Facilitation Services Participant Questionnaire (Rev2011).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	3320-000N(1)	Facilitation Services - Participant Questionnaire Rev 2012	Facilitation Services Participant Questionnaire _Rev2012_.pdf	Note; Currently being completed	Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 530

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	530	-70	600
Annual IC Time Burden (Hours)	106	-94	200
Annual IC Cost Burden (Dollars)	0	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.