Information Collection

Building Better Caregivers TM Alumni Community Satisfaction Survey

IC 211244 under ICR 201107-2900-001 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-10119 Building Better Caregivers TM Alumni Community Satisfaction Survey	Form and Instruction
10-10119 Building Better Caregivers TM Alumni Community Satisfact Alumni Survey Final 4-15-14.docx	Form and Instruction
OMB BBC Alumni Satisfaction Request_20140324.docx Fast Track Building Better Caregivers TM Alumni Community Satisfaction Survey Justification	IC Document

IC Title:

Building Better Caregivers TM Alumni Community Satisfaction 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	10-10119	Building Better Caregivers TM Alumni Community Satisfaction Survey	Alumni Survey Final 4-15-14.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	500	500
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Building Better Caregivers TM Alumni Community Satisfaction Survey Justification	OMB BBC Alumni Satisfaction Request_20140324.docx	04/11/2014

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