Information Collection

CDC TRAIN Delayed Follow-up Evaluation Tool

IC 250802 under ICR 202111-0920-020 · OMB 0920-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0017 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CDC TRAIN Delayed Follow-up Evaluation Tool	Form and Instruction
CDC TRAIN Delayed Follow-Up Evaluation Tool Attachment_8_Appl_for_Trng_CDC_TRAIN_Delayed_Follow-up_Trng_Eval.pdf	Form and Instruction

IC Title:

CDC TRAIN Delayed Follow-up Evaluation Tool

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
Form and Instruction	n/a	CDC TRAIN Delayed Follow-Up Evaluation Tool	Attachment_8_Appl_for_Trng_CDC_TRAIN_Delayed_Follow-up_Trng_Eval.pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: 09-20-01610-Records of Health Professionals in Disease Prevention and Control Training Programs

FR Citation: 51 FR 42485

Number of Respondents: 30,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90,000	90,000
Annual IC Time Burden (Hours)	3,000	3,000
Annual IC Cost Burden (Dollars)	146,160	146,160

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.