Information Collection

Survey on Evaluation Technical Assistance Received by State Peer Cohorts

IC 273906 under ICR 202304-1205-001 · OMB 1205-0436.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation_PLC_Survey_SWA_TA_2025.docx	Other-Survey
Generic Clearance Submission Template_EvalPLC_survey 1.29.25.docx Survey on Evaluation Technical Assistance Received by State Peer Cohorts	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 682.220 5 CFR 1320.5

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			Evaluation_PLC_Survey_SWA_TA_2025.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	240	240
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey on Evaluation Technical Assistance Received by State Peer Cohorts	Generic Clearance Submission Template_EvalPLC_survey 1.29.25.docx	01/30/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.