Awardee Administrators Program Survey

WISEWOMAN National Program Evaluation: Implementation Assessment

OMB: 0920-1068

IC ID: 214149

Information Collection (IC) Details

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Awardee Administrators Program Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Awardee Administrators Program Survey Attachment C1 WISEWOMAN program survey.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

15 0
   
State, Local, and Tribal Governments
 
   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 15 0 15 0 0 0
Annual IC Time Burden (Hours) 15 0 15 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Survey Invitation Attachment C2 Program survey invitation.docx 12/04/2014
Survey Reminder Attachment C3 Program survey reminder.docx 12/04/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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