Information Collection

Evaluation Form for PAESMEM Recognition Event

IC 216856 under ICR 201402-3145-001 · OMB 3145-0215.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0215 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation Form_PAESMEM 2015.doc	Other-Customer Satisfaction Survey
2015PAESMEMRecognitionEventGenericClearance06032015 (2).docx Supporting Statement for PAESMEM Event	IC Document
SPPAESMEM2015RecognitionEventAwardeeGuests06032015.xlsx Attendees	IC Document

IC Title:

Evaluation Form for PAESMEM Recognition Event

Agency IC Tracking Number:

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
Other-Customer Satisfaction Survey			Evaluation Form_PAESMEM 2015.doc		No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	31	31
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement for PAESMEM Event	2015PAESMEMRecognitionEventGenericClearance06032015 (2).docx	06/03/2015
Attendees	SPPAESMEM2015RecognitionEventAwardeeGuests06032015.xlsx	06/03/2015

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