Information Collection

Mentor Survey

IC 244800 under ICR 202012-1405-002 · OMB 1405-0242.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Updated MENTOR SURVEY_v2 Clean11.17.2020.docx	Other-Survey
Updated MENTOR SURVEY_v2 Clean11.17.2020.docx	Other-Survey
Revised-Screenshots-DOS TechWomen-Mentors Survey.pdf	Other-Screenshots
Revised-Screenshots-DOS TechWomen-Mentors Survey.pdf	Other-Screenshots

IC Title:

Mentor Survey

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-Survey					Yes	Yes	Fillable Fileable
Other-Screenshots					Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 946

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	709	709
Annual IC Time Burden (Hours)	355	355
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.

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