Information Collection

Restaurant intervention log - intervention restaurants

IC 245315 under ICR 202204-0920-004 · OMB 0920-1227.

Documents and Forms

Document Name Document Type
Restaurant intervention log - intervention restaurants Form
Restaurant intervention log P_Att 5 Intervention Log 201211.docx Form
Restaurant intervention log P_Att 5 Intervention Log 201211.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Restaurant intervention log - intervention restaurants	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	Restaurant intervention log	P_Att 5 Intervention Log 201211.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	53	53
Annual IC Time Burden (Hours)	27	27
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.