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Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire
Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire
OMB: 0607-0404
IC ID: 3428
OMB.report
DOC/CENSUS
OMB 0607-0404
ICR 201212-0607-001
IC 3428
( )
Documents and Forms
Document Name
Document Type
BC1294 Changes 12-2011.doc
Other-Proposed Changes to BC-1294
BC-1294(D) Decennial Field Staff Exit Questionnaire
BC-1294(D) (05-06-09).pdf
Form
BC-1294 Field Representative Exit Questionnaire
bc1294.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire
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
Other-Proposed Changes to BC-1294
BC1294 Changes 12-2011.doc
No
Paper Only
Form
BC-1294(D)
Decennial Field Staff Exit Questionnaire
BC-1294(D) (05-06-09).pdf
No
Paper Only
Form
BC-1294
Field Representative Exit Questionnaire
bc1294.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
650
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
650
0
0
0
0
650
Annual IC Time Burden (Hours)
84
0
0
0
0
84
Annual IC Cost Burden (Dollars)
0
0
0
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.