Information Collection

2016 SPORE Administrators Workshop Evaluation

IC 223538 under ICR 201406-0925-004 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 2016 SPORE Administrators Workshop Evaluation	Form and Instruction
1 2016 SPORE Administrators Workshop Evaluation-Paper onli 2016 SPORE Administrators workshop evaluation-paper_online_combined.pdf	Form and Instruction
SPORE Fast Track Request.docx SPORE Fast Track	IC Document

IC Title:

2016 SPORE Administrators Workshop Evaluation

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
Form and Instruction	1	2016 SPORE Administrators Workshop Evaluation-Paper online combined	2016 SPORE Administrators workshop evaluation-paper_online_combined.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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	100	100
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SPORE Fast Track	SPORE Fast Track Request.docx	09/14/2016

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