Information Collection

PCFDI Faculty Skill and Program Feasibility Survey

IC 207442 under ICR 201306-0915-003 · OMB 0915-0370.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 PCFDI Faculty Skill and Program Feasibility Survey	Form
2 PCFDI Irvine's Leadership Behavior Survey PCFDI Leadership Behavior Survey final.docx	Form
1 PCFDI Faculty Skill and Program Feasibility Survey PCFDI Faculty Skill Feasibility Survey Final.docx	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	2	PCFDI Irvine's Leadership Behavior Survey	PCFDI Leadership Behavior Survey final.docx		Yes	Yes	Fillable Fileable
Form	1	PCFDI Faculty Skill and Program Feasibility Survey	PCFDI Faculty Skill Feasibility Survey Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36

Number of Respondents for Small Entity: 36

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36	36
Annual IC Time Burden (Hours)	15	15
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.