Information Collection

Formative Evaluation of Professional Development Resources - Web Survey

IC 235815 under ICR 201808-0920-023 · OMB 0920-0840.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0840 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0840 Formative Evaluation of Professional Development Resources - Web Survey Formative Evaluation of Professional Development Resources - Web Survey	Form and Instruction
Att 3_Survey.docx	Other-WORD
0920-0840 Formative Evaluation of Professional Development Resourc Att 3a_Screen Shots of Survey.pdf	Form and Instruction
SS A.doc Supporting Statement A	IC Document
SS B.docx Supporting Statement B	IC Document
Att 1_Auth Legislation.doc Att 1_ Authorizing Leg	IC Document
Att 2_60 Day FRN.pdf Att 2_60dy FRN	IC Document
Att 4_Consultants.docx Att 4_Consultant	IC Document
Att 5_Informed Consent.docx Att 5_ Informed Consent	IC Document
Att 6_Email Invite_Reminder Email.docx Att 6_Email Invite_Reminder	IC Document
Att 7_ICF IRB Exempt Approval Documents 2-11-19.pdf Att 7_ICF IRB	IC Document
Att 8_Respondent Universe.docx Att 8_Respondent Universe	IC Document

IC Title:

Formative Evaluation of Professional Development Resources - Web Survey

Agency IC Tracking Number:

0920-0840-19ANZ

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 and Instruction	0920-0840				Yes	Yes	Fillable Fileable
Other-WORD					No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 475

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	475	475
Annual IC Time Burden (Hours)	174	174
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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