Information Collection

Teacher Questionnaire (Time 2)

IC 242969 under ICR 202008-0920-001 · OMB 0920-1320.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Teacher Questionnaire (Time 2)	Form and Instruction
Lead Health Education Teacher Questionnaire AttD-Lead Health Edu Teacher Ques 4-1-20.docx	Form and Instruction
Lead Health Education Teacher Questionnaire AttD-Lead Health Edu Teacher Ques 4-1-20.docx	Form and Instruction

IC Title:

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 and Instruction	n/a	Lead Health Education Teacher Questionnaire	AttD-Lead Health Edu Teacher Ques 4-1-20.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	4,650	4,650

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.