Information Collection

Technical Assistance Workshop (TAW) – Participant Feedback (NCI)

IC 242585 under ICR 202002-0925-002 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Technical Assistance Workshop (TAW) – Participant Feedback (NCI)	Form and Instruction
1 TAW 2020 Survey screenshots TAW 2020 Evaluation Survey Screenshots_rev.pdf	Form and Instruction
TAW 2020 Fast Track Sub-Study FINAL.docx TAW 2020 fast track stub-study	IC Document
TAW Invitation email.docx TAW email invitation	IC Document

IC Title:

Technical Assistance Workshop (TAW) â Participant Feedback (NCI)

Agency IC Tracking Number:

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	1	TAW 2020 Survey screenshots	TAW 2020 Evaluation Survey Screenshots_rev.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
TAW 2020 fast track stub-study	TAW 2020 Fast Track Sub-Study FINAL.docx	07/06/2020
TAW email invitation	TAW Invitation email.docx	07/06/2020

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