Information Collection

Baseline survey and consent – program participants

IC 243182 under ICR 202008-1290-001 · OMB 1290-0034.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A - Baseline Survey and Consent Form for Program Participants.docx	Other-Baseline Survey and Consent

IC Title:

Baseline survey and consent â program participants

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
Other-Baseline Survey and Consent			Attachment A - Baseline Survey and Consent Form for Program Participants.docx		No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

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	5,000	5,000
Annual IC Time Burden (Hours)	1,667	1,667
Annual IC Cost Burden (Dollars)	0	0

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.