Information Collection

2019 NIOSH Centers Grantee Meeting Evaluation Survey

IC 237772 under ICR 201802-0920-007 · OMB 0920-0953.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2019 NIOSH Centers Grantee Meeting Evaluation Survey	Form
Grantee Meeting Evaluation NIOSH Centers Grantee Meeting Evaluation.docx	Form
Fast_Track_GenIC_RequestTemplate_9.17.19.docx Request for Approval	IC Document

IC Title:

2019 NIOSH Centers Grantee Meeting Evaluation Survey

Agency IC Tracking Number:

0920-0953-19BRQ

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	none	Grantee Meeting Evaluation	NIOSH Centers Grantee Meeting Evaluation.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 89

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	89	89
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Fast_Track_GenIC_RequestTemplate_9.17.19.docx	09/17/2019

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