Att H_Employer Follow-up Survey

CDC Work@Health Advance Program: Evaluation of Train-the-Trainer and Advanced Technical Assistance Program

OMB: 0920-1077

IC ID: 216866

Documents and Forms
Document Name
Document Type
Other-WORD Screenshots
Information Collection (IC) Details

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Att H_Employer Follow-up Survey 15OO
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Screenshots Att H_Employer Follow-Up Survey_4-20-15.docx Yes Yes Fillable Printable

Health Illness Prevention

 

120 60
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 120 0 120 0 0 0
Annual IC Time Burden (Hours) 30 0 30 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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