Post-TA evaluation

Capacity Building Assistance Program: Data Management, Monitoring, and Evaluation

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.