Information Collection

TA-Learning Event Feedback Survey

IC 202287 under ICR 201103-0930-003 · OMB 0930-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0197 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Follow-Up Learning TA-Learning Event Feedback Survey	Form and Instruction
On-Site Learning E On-Site Learning Event Feedback Form Attachment 1 On-Site Learning Event Feedback Form 5-24-12.docx	Form and Instruction
Follow-Up Learning Follow-Up Learning Event Feedback Form Attachment 2 Follow-Up Learning Event Feedback Form 5-24-12.docx	Form and Instruction
Trans.Let-3-2012.doc Trans Letter	IC Document
TA Partnership Customer Satisfaction Survey, 5-11-12.pdf Justification	IC Document

IC Title:

TA-Learning Event Feedback Survey

Agency IC Tracking Number:

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 and Instruction	Follow-Up Learning Event Feedback Form	Follow-Up Learning Event Feedback Form	Attachment 2 Follow-Up Learning Event Feedback Form 5-24-12.docx		Yes	Yes	Fillable Printable
Form and Instruction	On-Site Learning Event Feedback Form	On-Site Learning Event Feedback Form	Attachment 1 On-Site Learning Event Feedback Form 5-24-12.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 190

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	190	190
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Trans Letter	Trans.Let-3-2012.doc	05/15/2012
Justification	TA Partnership Customer Satisfaction Survey, 5-11-12.pdf	05/15/2012

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