Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire

Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire

OMB: 0607-0404

IC ID: 3428

Information Collection (IC) Details

View Information Collection (IC)

Field Representative Exit Questionnaire/Decennial Field Staff Exit Questionnaire/Continuous Measurement Exit Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form BC-1294(D) Decennial Field Staff Exit Questionnaire BC-1294(D).pdf No   Paper Only
Form BC-1294 Field Representative Exit Questionnaire BC-1294.pdf No   Paper Only
Other-Proposed Changes to BC-1294 BC1294 Changes.doc No   Paper Only
Other-Proposed Changes to BC-1294(D) BC1294D changes.doc No   Paper Only
Form BC-1294(CM) Coverage Measurement Exit Questionnaire bc1294ccm.pdf No   Paper Only

General Government Central Records & Statistical Mgt

 

2,500 0
   
Individuals or Households
 
   0 %

  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 2,500 0 500 1,355 0 645
Annual IC Time Burden (Hours) 393 0 83 226 0 84
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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