Information Collection

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

IC 231810 under ICR 201510-0923-001 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.