OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

WIPA Provider Survey

IC 278836 under ICR 202604-0960-002 · OMB 0960-0847.

Documents and Forms
Document Name
Document Type
Other-Survey Invitaton Email (Week 1
Other-Survey Invitation Email (Week
Other-Survey Invitation Email (Week
Other-Survey Invitation Email (Week
Other-Survey Invitation Email (Week
Other-Survey Invitation Email (Week
Other-Survey Instrument
Information Collection (IC) Details

View Information Collection (IC)

WIPA Provider Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Invitaton Email (Week 1) Attachment A2a - WIPA Provider Survey Invitation Letter (Week 1).docx Yes No Printable Only
Other-Survey Invitation Email (Week 1.5) Attachment A2b - WIPA Provider Survey Invitation Email (Week 1.5).docx Yes No Printable Only
Other-Survey Invitation Email (Week 3) Attachment A2c - WIPA Provider Survey Reminder Email (Week 3).docx Yes No Printable Only
Other-Survey Invitation Email (Week 4.5) Attachment A2d - WIPA Provider Survey Reminder Email (Week 4.5).docx Yes No Printable Only
Other-Survey Invitation Email (Week 6) Attachment A2e - WIPA Provider Survey Reminder Email (Week 6).docx Yes No Printable Only
Other-Survey Invitation Email (Week 7.5) Attachment A2f - WIPA Provider Survey Reminder Email (Week 7.5).docx Yes No Printable Only
Other-Survey Instrument Attachment A2g - WIPA Provider Survey Instrument (Revised Clean Copy).docx Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

59 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 59 0 0 0 0 59
Annual IC Time Burden (Hours) 37 0 0 0 0 37
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
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