Information Collection

Assessing Satisfaction with Technical Assistance (TA) Provided to Racial and Ethnic Approaches to Community Health (REACH) Awardees

IC 226107 under ICR 201408-0920-009 · OMB 0920-0800.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0800 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
5. Facilitators Guide_030917.docx	Other-WORD
4. Group Discussion Questions_ 030917.docx	Other-WORD
1. Invitation email_020917.doc Invitation Email	IC Document
2. Reminder email_020917.doc Reminder Email	IC Document
3. Consent form_020917.docx Consent Form	IC Document
6. Thank you email_020917.doc Thank You Email	IC Document
GenIC_DCH Training and TA_03.16.2017.docx Request for Approval	IC Document

IC Title:

Assessing Satisfaction with Technical Assistance (TA) Provided to Racial and Ethnic Approaches to Community Health (REACH) Awardees

Agency IC Tracking Number:

17TG

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-WORD			4. Group Discussion Questions_ 030917.docx		No		Paper Only
Other-WORD			5. Facilitators Guide_030917.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	60	60
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation Email	1. Invitation email_020917.doc	03/17/2017
Reminder Email	2. Reminder email_020917.doc	03/17/2017
Consent Form	3. Consent form_020917.docx	03/17/2017
Thank You Email	6. Thank you email_020917.doc	03/17/2017
Request for Approval	GenIC_DCH Training and TA_03.16.2017.docx	03/17/2017

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