Information Collection

FASD Training Evaluation

IC 220421 under ICR 202102-0920-003 · OMB 0920-1129.

Documents and Forms

Document Name Document Type
FASD Training Evaluation Form
FASD Training Evaluation I3 Pediatric FASD Regional Liaison & Champion Training Session Evaluation.docx Form
FASD Training Evaluation I3 Pediatric FASD Regional Liaison & Champion Training Session Evaluation.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FASD Training Evaluation	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 Evaluation	I3 Pediatric FASD Regional Liaison & Champion Training Session Evaluation.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.