Information Collection

Program attendance and content coverage protocol

IC 215077 under ICR 201502-0990-005 · OMB 0990-0428.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0428 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-NEW_ PAF Instrument 5_Program Attendance Data Collection Protocol.docx	Other-Data
0990-New-PAF Attachment D_Confidentiality Pledge.pdf Confidentiality Pledge	IC Document

IC Title:

Program attendance and content coverage protocol

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
Other-Data					No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

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	24	24
Annual IC Time Burden (Hours)	12	12
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Confidentiality Pledge		02/24/2015

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

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