Information Collection

State Exchange on Employment and Disability (SEED) Evaluation Survey

IC 224921 under ICR 201612-1230-001 · OMB 1230-0011.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SEED Survey_Final.pdf websurveyor2.airws.org/Community/se.ashx?s=2511374521585CAA	Instruction
Survey Cover Letter - 5_5.docx	Instruction
Screen shot of SEED survey.docx	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	SEED Survey_Final.pdf	http://websurveyor2.airws.org/Community/se.ashx?s=2511374521585CAA	Yes	Yes	Fillable Printable
Instruction	Survey Cover Letter - 5_5.docx		Yes	Yes	Fillable Printable
Instruction	Screen shot of SEED survey.docx		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	500	500
Annual IC Time Burden (Hours)	108	108
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.