Information Collection

Empowerment Convening Evaluation Questions

IC 205033 under ICR 201210-3170-001 · OMB 3170-0024.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0024 can be found here:

Documents and Forms

Document Name Document Type
Supplementary Information - Empowerment Convening Evaluation.pdf Other-Supplementary Information
3170-XXXX Empowerment Convening Evaluation Questions Empowerment Convening Evaluation Questions.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Empowerment Convening Evaluation Questions	Agency IC Tracking Number:

IC Status: New

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-Supplementary Information			Supplementary Information - Empowerment Convening Evaluation.pdf		Yes	No	Fillable Printable
Form and Instruction	3170-XXXX	Empowerment Convening Evaluation Questions	Empowerment Convening Evaluation Questions.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	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
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	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.