Information Collection

Chair Training

IC 200723 under ICR 201108-0925-006 · OMB 0925-0474.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0474 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Chair Training	Form and Instruction
1 Chair Training CSR ChairTraining survey rev.docx	Form and Instruction
ChairTrainingMemo rev.doc ChairTrainingMemo rev	IC Document
CSR_ChairTrainingSurvey_generic_form rev.doc CSR_ChairTrainingSurvey_generic_form rev	IC Document

IC Title:

Chair Training

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	1	Chair Training	CSR ChairTraining survey rev.docx		Yes	Yes	Fillable Fileable

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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	500	0	0	0	0	0
Annual IC Time Burden (Hours)	83	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ChairTrainingMemo rev	ChairTrainingMemo rev.doc	01/09/2012
CSR_ChairTrainingSurvey_generic_form rev	CSR_ChairTrainingSurvey_generic_form rev.doc	01/09/2012

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