Information Collection

Post-TA evaluation

IC 242739 under ICR 202007-0920-013 · OMB 0920-1322.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1322 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Post-TA evaluation	Form
Post-TA evaluation Att 10_Post-Technical Assistance Evaluation-Screenshots.docx	Form
Post-TA evaluation -word Att 9_Post-Technical Assistance Evaluation-Word version.docx	Form

IC Title:

Post-TA evaluation

Agency IC Tracking Number:

Is this a Common Form? No

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	Post-TA evaluation	Att 10_Post-Technical Assistance Evaluation-Screenshots.docx		Yes	Yes	Fillable Fileable
Form	none	Post-TA evaluation -word	Att 9_Post-Technical Assistance Evaluation-Word version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Records of Health Professionals in Disease Prevention and Control Training Programs.

FR Citation: 51 FR 42485

Number of Respondents: 3,650

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,300	7,300
Annual IC Time Burden (Hours)	608	608
Annual IC Cost Burden (Dollars)	14,381	14,381

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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