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Federal forms, ICRs, and supporting documents

Information Collection

Learn the Signs. Act Early. Partner Webinars

IC 214699 under ICR 201410-0920-001 · OMB 0920-0919.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Learn the Signs. Act Early. Partner Webinars 15GF
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Iniital survey Att1 InitialSurvey Edited Dec 2 2014 - DG+CP.docx Yes Yes Fillable Fileable
Form none Initial survey - screenshots Att1a Screenshots-Initial 12-3-14.docx Yes Yes Fillable Fileable
Form none Follow-up survey Att2 FollowUpSurvey Edited Nov 12 2014 - DG+CP.docx Yes Yes Fillable Fileable
Form none Follow-up survey - screenshots Att2a Screenshots-Follow up 12-3-14.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

1,200 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,200 0 1,200 0 0 0
Annual IC Time Burden (Hours) 40 0 40 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval OMB LTSAE Webinar DRAFT SUBMISSION Rev Dec 2 2014 DG+CP.docx 01/21/2015
Recruitment emails Att3.RecruitmentEmail.docx 01/21/2015
Webinar materials Att4.LTSAE Webinar Powerpoint Slides.pptx 01/21/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.