CAP Follow-up Survey Form

IMLS Collections Assessment for Preservation Forms

Documents and Forms

Document Name Document Type
Form CAP Follow-up Surv CAP Follow-up Survey Form Form and Instruction
CAP Follow-up Surv CAP Follow-up Survey Form 3137-0126 CAP Participant One Year Follow-Up Survey_20240417.docx Form and Instruction
CAP Follow-up Surv CAP Follow-up Survey Form 3137-0126 CAP Participant One Year Follow-Up Survey_20240417.docx Form and Instruction
CAP Follow-Up Survey Form-20210309.docx FY21 CAP Follow-up Survey Form IC Document
CAP Follow-Up Survey Form-20210309.docx FY21 CAP Follow-up Survey Form IC Document

Information Collection (IC) Details

IC Title:	CAP Follow-up Survey Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	CAP Follow-up Survey Form 1	CAP Follow-up Survey Form	3137-0126 CAP Participant One Year Follow-Up Survey_20240417.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 80

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	25	0	25
Annual IC Cost Burden (Dollars)	811	100	711

Documents for IC

Title	Document	Date Uploaded
FY21 CAP Follow-up Survey Form	CAP Follow-Up Survey Form-20210309.docx	04/17/2024

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