Information Collection

Regional Extenion Center

IC 195150 under ICR 201604-0955-001 · OMB 0955-0009.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0009 can be found here:

Documents and Forms

Document Name Document Type
0990- REC Operation Plan Template RECs.xls Other-crm tools
0955-0009 Workforce Survey_v9_2016.doc Other-survey
0990-REC CRM Tool Screenshots.doc 0990-REC CRM Tool Screenshots IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Regional Extenion Center	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-crm tools			0990- REC Operation Plan Template RECs.xls		No	No	Paper Only
Other-survey			0955-0009 Workforce Survey_v9_2016.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	720	720
Annual IC Time Burden (Hours)	1,080	1,080
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0990-REC CRM Tool Screenshots	0990-REC CRM Tool Screenshots.doc	10/21/2010

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