Information Collection

[CSELS] Six-Month Follow-up Survey of PHIT Registrants from PH Agencies

IC 256936 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⚠️ Notice: This information collection may be referencing outdated material.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 Six-Month Follow-up Survey of PHIT Registrants from Public Health Agencies [CSELS] Six-Month Follow-up Survey of PHIT Registrants from PH Agencies	Form and Instruction
Attachment A - Instrument_Word Version.docx	Other-WORD
0920-0879 Six-Month Follow-up Survey of PHIT Registrants from Publ Attachment B - Instrument_Web Version.docx	Form and Instruction
Post-PHIT22-SSA_final.docx SSA	IC Document
Post-PHIT22-SSB_final.docx SSB	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:

[CSELS] Six-Month Follow-up Survey of PHIT Registrants from PH Agencies

Agency IC Tracking Number:

0920-0879-23BC

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-WORD					No		Paper Only
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: 661

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	661	661
Annual IC Time Burden (Hours)	66	66
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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