Information Collection

Student Program Master Trainer Technical Assistance Tracking Form

IC 201415 under ICR 201512-0920-010 · OMB 0920-0941.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
STUDENT PROGRAM MASTER TRAINER TECHNICAL ASSISTANCE TRACKING FORM	Form
Master Trainer TA Tracking Form Atmt_DDDD_Student_Program_Master_Trainer_TA_Track__Form-FINAL[1].docx	Form

IC Title:

STUDENT PROGRAM MASTER TRAINER TECHNICAL ASSISTANCE TRACKING FORM

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
Form	None	Master Trainer TA Tracking Form	Atmt_DDDD_Student_Program_Master_Trainer_TA_Track__Form-FINAL[1].docx		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-600	600
Annual IC Time Burden (Hours)	-100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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