Project Director Survey

Multiplier Surveys

Documents and Forms

Document Name Document Type
Form Project Director S Project Director Survey Form and Instruction
Project Director S Project Director Survey Attachment A.docx Form and Instruction
Project Director S Project Director Survey Attachment_A_Final.docx Form and Instruction
Attachment C.docx Roster IC Document

Information Collection (IC) Details

IC Title:	Project Director Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Project Director Survey	Project Director Survey	Attachment A.docx		Yes	Yes	Paper Only
Form and Instruction	Project Director Survey	Project Director Survey	Attachment_A_Final.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Roster	Attachment C.docx	08/17/2010

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