Information Collection

Government Official (city, town, county)

IC 200706 under ICR 201502-0990-013 · OMB 0990-0388.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Final Baseline Survey_LMCTC 11012.docx	Other-Survey
0990-Let's Move! Cities Towns and Countries MEMO.pdf 0990-Let's Move! Cities Towns and Countries MEMO	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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-Survey			Final Baseline Survey_LMCTC 11012.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,000	1,000
Annual IC Time Burden (Hours)	-250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990-Let's Move! Cities Towns and Countries MEMO	0990-Let's Move! Cities Towns and Countries MEMO.pdf	01/05/2012

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