Follow-Up Surveys, 18 and 36 months

Follow-Up Survey Information for Green Jobs and Health Care Impact Evaluation, American Recovery Reinvestment Act Grants

Documents and Forms

Document Name Document Type
GJ-HC_EVALUATION_FOLLOW-UP_SURVEY fpr 18 and 36 months.docx Other-survey
Green_Jobs_Advance_letter_2 2013 final.docx Letter IC Document
GJ-HC_Higher Incentive Reminder Letter_FORM.docx Advance Letter IC Document

Information Collection (IC) Details

IC Title:	Follow-Up Surveys, 18 and 36 months	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-survey			GJ-HC_EVALUATION_FOLLOW-UP_SURVEY fpr 18 and 36 months.docx		Yes	Yes	Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,304	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,304	1,280	4,024
Annual IC Time Burden (Hours)	2,918	705	2,213
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Letter	Green_Jobs_Advance_letter_2 2013 final.docx	02/12/2013
Advance Letter	GJ-HC_Higher Incentive Reminder Letter_FORM.docx	08/29/2013

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