Information Collection

Student Outcome Survey Baseline

IC 201395 under ICR 201207-0920-010 · OMB 0920-0941.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0941 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Student Outcome Survey Baseline Form and Instruction
1 Student Outcome Survey -- Baseline Atmt D Student Outcome Survey Baseline_11-21-11.docx Form and Instruction
no number Student Baseline Outcome Survey Atmt_D_Student_Outcome_Survey_Baseline_corrected.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Student Outcome Survey Baseline	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
Form and Instruction	1	Student Outcome Survey -- Baseline	Atmt D Student Outcome Survey Baseline_11-21-11.docx		No	No	Paper Only
Form and Instruction	no number	Student Baseline Outcome Survey	Atmt_D_Student_Outcome_Survey_Baseline_corrected.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,286	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	11,286	-3,762	15,048
Annual IC Time Burden (Hours)	8,465	-2,821	11,286
Annual IC Cost Burden (Dollars)	0	0	0

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.