#1 - Grantee Census Survey Protocol Table

Evaluation of Early Learning Mentor Coaches (ELMC) Grants

Documents and Forms

Document Name Document Type
Attachment 1. Grantee Census Survey Protocol_110411_FINAL.doc Other-Attachment 1. Grantee Census S

Information Collection (IC) Details

IC Title:	#1 - Grantee Census Survey Protocol Table	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Attachment 1. Grantee Census Survey Protocol_110411_FINAL			Attachment 1. Grantee Census Survey Protocol_110411_FINAL.doc		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 130	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	65	65
Annual IC Cost Burden (Dollars)	1,828	1,828

Documents for IC

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.