Information Collection

State, Tribal, Local, and Territorial PHIT Attendee Follow-up Survey

IC 250062 under ICR 202011-0920-003 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0879 State, Tribal, Local, and Territorial PHIT Attendee Follow-up Survey State, Tribal, Local, and Territorial PHIT Attendee Follow-up Survey	Form and Instruction
0920-0879 State, Tribal, Local, and Territorial PHIT Attendee Foll Attachment B - Instrument Web Version.docx	Form and Instruction
Post-PHIT-SSA.docx Supporting Statement A	IC Document
Post-PHIT-SSB.docx Supporting Statement B	IC Document
Attachment A - Instrument Word Version.docx State, Tribal, Local, and Territorial PHIT Attendee Six-Month Follow-up Survey	IC Document
Attachment C - Survey Invitation Email.docx Survey Invitation Email	IC Document
Attachment D - Initial Reminder Email.docx Initial Reminder Email	IC Document
Attachment E - Final Reminder Email.docx Final Reminder Email	IC Document

IC Title:

State, Tribal, Local, and Territorial PHIT Attendee Follow-up Survey

Agency IC Tracking Number:

0920-0879-22AM

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	0920-0879				Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 525

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	525	525
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A		11/03/2021
Supporting Statement B		11/03/2021
State, Tribal, Local, and Territorial PHIT Attendee Six-Month Follow-up Survey		11/03/2021
Survey Invitation Email		11/03/2021
Initial Reminder Email		11/03/2021
Final Reminder Email		11/03/2021

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

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