Information Collection

Post-Implementation Survey for Parents

IC 200249 under ICR 201111-0920-006 · OMB 0920-0911.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6 Post-Implementation Survey for Parents	Form and Instruction
6 A Post-Implementaion Survey for Parents-Spanish Att 3F Post-implementation Survey for Parents (Spanish) 9 9 11.docx	Form and Instruction
5 A Post-Implementation Survey for Parents-English Att 3E Post-implementation Survey for Parents (English) 9 9 11.docx	Form and Instruction
3E LTSAE ATT3E Post-Implementation Survey for Parents (Engl LTSAE att3E Post-implementation Survey for Parents (English) OMB Rev.doc	Form and Instruction
3F LTSAE ATT3F Post-Implementation Survey for Parents (Span LTSAE att3F Post-implementation Survey for Parents (Spanish) OMB Rev.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6	A Post-Implementaion Survey for Parents-Spanish	Att 3F Post-implementation Survey for Parents (Spanish) 9 9 11.docx	Yes	No	Paper Only
Form and Instruction	5	A Post-Implementation Survey for Parents-English	Att 3E Post-implementation Survey for Parents (English) 9 9 11.docx	Yes	No	Paper Only
Form and Instruction	3F	LTSAE ATT3F Post-Implementation Survey for Parents (Spanish) OMB	LTSAE att3F Post-implementation Survey for Parents (Spanish) OMB Rev.doc	Yes	No	Paper Only
Form and Instruction	3E	LTSAE ATT3E Post-Implementation Survey for Parents (English) OMB	LTSAE att3E Post-implementation Survey for Parents (English) OMB Rev.doc	Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

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	1,000	1,000
Annual IC Time Burden (Hours)	167	167
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.