Information Collection

Aging Worker Initiative Evaluation

IC 196156 under ICR 201101-1205-002 · OMB 1205-0483.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AWI-Master-Protocol-final2.docx	Other-survey
Additional data requested - AWI.doc	Other-data fields
AWI--Protocols for respondents revised 9_21_11cas.doc	Other-protocols

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	AWI-Master-Protocol-final2.docx	Yes	No	Fillable Fileable Signable
Other-data fields	Additional data requested - AWI.doc	Yes	Yes	Fillable Fileable
Other-protocols	AWI--Protocols for respondents revised 9_21_11cas.doc	Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,300	7,300
Annual IC Time Burden (Hours)	4,407	4,407
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.