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Bullying Prevention Online Course –Evaluation Questions - Course Specific
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0920-1009
IC ID: 230144
OMB.report
HHS/CDC
OMB 0920-1009
ICR 201612-0920-007
IC 230144
( )
Documents and Forms
Document Name
Document Type
Form 0920-1009
Bullying Prevention Online Course –Evaluation Questions - Course Specific
Form and Instruction
0920-1009 Course Specific Evaluation Questions
Att.A_ Course Specific Evaluation Questions 1-16-18.DOCX
Form and Instruction
109_GenIC_Request_Bullying Prevention Online Course_21FEB2018.docx
GenIC Request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Bullying Prevention Online Course –Evaluation Questions - Course Specific
Agency IC Tracking Number:
0920-1009-18MK
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 and Instruction
0920-1009
Course Specific Evaluation Questions
Att.A_ Course Specific Evaluation Questions 1-16-18.DOCX
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,500
0
4,500
0
0
0
Annual IC Time Burden (Hours)
225
0
225
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
GenIC Request
109_GenIC_Request_Bullying Prevention Online Course_21FEB2018.docx
02/21/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.