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Regional Extenion Center
Regional Extension Center Cooperative Agreement Program (CRM Tool)
OMB: 0955-0009
IC ID: 195150
OMB.report
HHS/ONC
OMB 0955-0009
ICR 201705-0955-001
IC 195150
( )
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
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
7
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
875
0
155
0
0
720
Annual IC Time Burden (Hours)
1,313
0
0
233
0
1,080
Annual IC Cost Burden (Dollars)
0
0
0
0
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.