Information Collection

Process Evaluation of the EIA Program - Paper Survey Editorial Review Board

IC 204292 under ICR 201308-0925-004 · OMB 0925-0665.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Paper Survey for Editorial Board Reviewers Process Evaluation of the EIA Program - Paper Survey Editorial Review Board	Form and Instruction
1 Paper Survey for Editorial Board Reviewers Attachment A.2 - Paper Survey for Editorial Board Reviewers.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1				No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

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	Previously Approved
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	4	4
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.

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