Post-Meeting Survey of Attendees of 2018 Environmental PH Tracking Grantee Workshop

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
Post-Meeting Survey of Attendees of 2018 Environmental PH Tracking Grantee Workshop Form
Post-workshop survey - screenshots Attachment B - 2018 Tracking Workshop Post Survey_screenshot.pdf Form
0923-0047_TrackingGenIC.pdf Request for Approval IC Document
Attachment A - Email Invite for 2018 TRACKING WORKSHOP Feedback.docx Email Invitation IC Document
Attachment C - 2018 Tracking Workshop Post Survey_text.docx Survey - word IC Document

Information Collection (IC) Details

IC Title:	Post-Meeting Survey of Attendees of 2018 Environmental PH Tracking Grantee Workshop	Agency IC Tracking Number:	0923-0047-18AOA

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Post-workshop survey - screenshots	Attachment B - 2018 Tracking Workshop Post Survey_screenshot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 154	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	154	154
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	0923-0047_TrackingGenIC.pdf	06/14/2018
Email Invitation	Attachment A - Email Invite for 2018 TRACKING WORKSHOP Feedback.docx	06/14/2018
Survey - word	Attachment C - 2018 Tracking Workshop Post Survey_text.docx	06/14/2018

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