Information Collection

Level 1 Evaluation of Programs - Forums Eval

IC 239012 under ICR 201911-1103-003 · OMB 1103-0117.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0117 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1103-0117 Forums Eval Level 1 Evaluation of Programs - Forums Eval	Form and Instruction
1103-0117 Forums Eval 4. Forum Program Eval Form-Draft 12.12.2019.jpg	Form and Instruction
CRS OMB Clearance Submission 4- Forums Eval.doc Fast Track Template - Forums Eval	IC Document

IC Title:

Level 1 Evaluation of Programs - Forums Eval

Agency IC Tracking Number:

1103-0117

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	1103-0117	Forums Eval	4. Forum Program Eval Form-Draft 12.12.2019.jpg		No		Paper Only

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Template - Forums Eval	CRS OMB Clearance Submission 4- Forums Eval.doc	12/19/2019

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