OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

FASD Toolkit User Survey

IC 220417 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms
Document Name
Document Type
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

FASD Toolkit User Survey 17ADN
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none FASD Toolkit User Survey FASD Toolkit User Survey.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

50 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 0 -50 50 0
Annual IC Time Burden (Hours) 0 0 0 -13 13 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
FASD Toolkit User Survey - word FASD Toolkit User Survey_Edited.docx 05/09/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.