Information Collection

Post-Meeting Survey of Attendees at the 2018 Childhood Lead Poisoning Prevention Annual Cooperative Agreement Recipient's Meeting

IC 234516 under ICR 201605-0920-001 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 Post-Meeting Survey of Attendees at the 2018 Childhood Lead Poisoning Prevention Annual Cooperative Agreement Recipient's Meeting	Form and Instruction
0920-1050 0920-1050 Attachment C - Lead Poisoning Prevention Recipient Meeting Survey_text_AE.docx	Form and Instruction
0920-1050 GenIC Request Form.pdf GenIC Request Form	IC Document
Attachment A - Email Invite for 2018 Lead Poisoning Prevention Recipient Meeting Survey.docx Email Invite	IC Document
Attachment B - Lead Poisoning Prevention Recipient Meeting Survey_screenshot.docx Survey Screen Shots	IC Document

IC Title:

Post-Meeting Survey of Attendees at the 2018 Childhood Lead Poisoning Prevention Annual Cooperative Agreement Recipient's Meeting

Agency IC Tracking Number:

0920-1050-19IW

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 and Instruction	0920-1050	0920-1050	Attachment C - Lead Poisoning Prevention Recipient Meeting Survey_text_AE.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	150	150
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
GenIC Request Form	0920-1050 GenIC Request Form.pdf	12/14/2018
Email Invite	Attachment A - Email Invite for 2018 Lead Poisoning Prevention Recipient Meeting Survey.docx	12/14/2018
Survey Screen Shots	Attachment B - Lead Poisoning Prevention Recipient Meeting Survey_screenshot.docx	12/14/2018

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