Information Collection

Evaluation of State Vocational Rehabilitation Agency Administration of Supported Employment Programs

IC 201930 under ICR 201204-1820-001 · OMB 1820-0695.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation of State Vocational Rehabilitation Agency Administration of Supported Employment Programs	Form and Instruction
Online Survey of State Vocational Rehabilitation (VR) Ag SE_Online_Survey_rev_7_3_12.doc	Form and Instruction
1820-New (04796) Draft Respondent Letters_Emails.doc Draft Respondent Correspondence	IC Document
1820-New (04796) Survey Endorsements.doc Evaluation Endorsements	IC Document

IC Title:

Agency IC Tracking Number:

04796

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Online Survey of State Vocational Rehabilitation (VR) Agencies on Supported Employment (SE)	SE_Online_Survey_rev_7_3_12.doc		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

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	80	80
Annual IC Time Burden (Hours)	249	249
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Draft Respondent Correspondence	1820-New (04796) Draft Respondent Letters_Emails.doc	04/12/2012
Evaluation Endorsements	1820-New (04796) Survey Endorsements.doc	04/12/2012

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