Information Collection

Covid-19 Post Learning Community Survey

IC 246054 under ICR 202102-0937-001 · OMB 0937-0212.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf	Other-Survey
POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf	Other-Survey

IC Title:

COVID-19 POST LEARNING COMMUNITY 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			POST SURVEY ONLY COVID-19 Survey Instrument PRA.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-90-1901 HHS Correspondence, Customer Service, and Contact List Records

FR Citation: 86 FR 11306

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	17	17
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.