Information Collection

FASD Core Training - 6 month follow-up

IC 220378 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Document Name Document Type
FASD Core Training - 6 month follow-up Form
FASD Training Survey - follow-up N3 Core Six-Month Follow-Up Training Survey Screenshots.pdf Form
FASD Training Survey - follow-up N3 Core Six-Month Follow-Up Training Survey Screenshots.pdf Form
D3 Core Six-Month Followup -Training Survey.docx FASD Training Survey - followup - word IC Document
D3 Core Six-Month Followup -Training Survey.docx FASD Training Survey - followup - word IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FASD Core Training - 6 month follow-up	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	FASD Training Survey - follow-up	N3 Core Six-Month Follow-Up Training Survey Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,013	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-4,013	4,013
Annual IC Time Burden (Hours)	-401	401
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FASD Training Survey - followup - word	D3 Core Six-Month Followup -Training Survey.docx	03/02/2016

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