Form 77 ETCTN

OMB #0925-xxxx
Expiration Date: xx/xx/xxxx

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15

15

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Note: 4a appears conditionally if “yes” is selected in Q4.

Note: 4b and 4c appear together conditionally if “yes” is selected for any activities in
Q4a. 4b is populated with any activities identified as “yes” in Q4.

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Note: 5a and 5b appear together conditionally; they appear if “yes” is selected in
Q5.

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Note: 6a appears conditionally populated with any systems used 1 or more times in
Q6.

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Note: 6b appears conditionally, if the user has selected “not prepared” or “somewhat
prepared” for any items in Q6a.

Note: 6c and 6d appear together conditionally; 6c appears populated with any
systems used 1 or more times in Q6. 6d appears if 6c appears.

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Note: Q7b appears conditionally, populated with any resources used quarterly or
more frequently in Q7.

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