Information Collection

Midwest Academic Knowledge Pre-test

IC 204259 under ICR 201209-0920-008 · OMB 0920-0954.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Midwest Academic Knowledge Pre-test	Form
Midwest Academic Knowledge Pre-test F1_Midwest FASD Regional Training Center Knowledge Pre-Test.doc	Form

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Midwest Academic Knowledge Pre-test	F1_Midwest FASD Regional Training Center Knowledge Pre-Test.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,080

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	1,080	1,080
Annual IC Time Burden (Hours)	126	126
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.