Information Collection

Humphrey Evaluation Survey

IC 204906 under ICR 201211-1405-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SV-2012-0003 Humphrey Evaluation Survey	Form and Instruction
Humphrey Survey Variations Screen Shots (11-2012).pdf	Other-Variations Screenshots
SV-2012-0003 Humphrey Evaluation Survey Humphrey Survey Screenshots-Sector Modules (11-2012).docx	Form and Instruction
Humphrey Survey intro email (11-2012).docx Humphrey Evaluation Survey Introduction E-mail	IC Document
Humphrey Survey Reminder email (11-2012).docx Humphrey Evaluation Survey Reminder email	IC Document

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 and Instruction	SV-2012-0003	Humphrey Evaluation Survey	Humphrey Survey Screenshots-Sector Modules (11-2012).docx		Yes	Yes	Fillable Fileable
Other-Variations Screenshots			Humphrey Survey Variations Screen Shots (11-2012).pdf		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	648	648
Annual IC Time Burden (Hours)	324	324
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Humphrey Evaluation Survey Introduction E-mail	Humphrey Survey intro email (11-2012).docx	11/21/2012
Humphrey Evaluation Survey Reminder email	Humphrey Survey Reminder email (11-2012).docx	11/21/2012

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