Information Collection

Chesapeake Bay Program Citizen Stewardship Index, Diversity Profile, and Local Leadership Surveys

IC 249169 under ICR 202109-2003-001 · OMB 2003-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5800-055 Chesapeake Bay Program Citizen Stewardship Index, Diversity Profile, and Local Leadership Surveys	Form
5800-055 Recommended Survey Questions for Citizen Stewardship Citizen Stewardship Index Survey.pdf	Form
5800-055 Recommended Survey Questions for Citizen Stewardship Citizen Stewardship Index Survey.pdf	Form
5800-056 Diversity Profile Survey Diversity Profile Survey.pdf	Form and Instruction
5800-056 Diversity Profile Survey Diversity Profile Survey.pdf	Form and Instruction
5800-054 Local Leadership Survey Local Leadership Survey.pdf	Form and Instruction
5800-054 Local Leadership Survey Local Leadership Survey.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

2679.01

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5800-055	Recommended Survey Questions for Citizen Stewardship	Citizen Stewardship Index Survey.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5800-056	Diversity Profile Survey	Diversity Profile Survey.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	5800-054	Local Leadership Survey	Local Leadership Survey.pdf	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,430

Number of Respondents for Small Entity: 500

Affected Public: Individuals or Households

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	6,430	6,430
Annual IC Time Burden (Hours)	2,298	2,298
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.