Information Collection

Cooperative Studies Program (CSP) Site Survey and Meeting Evaluationi

IC 211083 under ICR 201403-2900-014 · OMB 2900-0772.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0772 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-0511 Cooperative Studies Program (CSP) Site Survey and Meeting Evaluationi	Form
10-0511 Cooperative Studies Program (CSP) Site Survey CSP_Site_Survey_10-0511_(1)[1].docx	Form
10-0511A Cooperative Studies Program (CSP) Meeting Evaluation CSP_Meeting_Evaluation_10-0511A_(3)[1].docx	Form

IC Title:

Cooperative Studies Program (CSP) Site Survey and Meeting Evaluationi

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	10-0511	Cooperative Studies Program (CSP) Site Survey	CSP_Site_Survey_10-0511_(1)[1].docx		No		Paper Only
Form	10-0511A	Cooperative Studies Program (CSP) Meeting Evaluation	CSP_Meeting_Evaluation_10-0511A_(3)[1].docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	500	500
Annual IC Time Burden (Hours)	0	0
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.