Evaluation of Mediation Services (Practitioner) - IC for Federal Respondents

Program Evaluation Instruments - Collaborative Problem Solving Mediation Services (Two Instruments)

Documents and Forms

Document Name Document Type
Form 3320-0004(2) Evaluation of Mediation Services (Practitioner) - IC for Federal Respondents Form and Instruction
3320-0004(2) Mediation Services - Practitioner Questionnaire (Rev 201 Mediation Services Practitioner Questionnaire (Rev 2011).pdf Note: Electronic version of instrument currently being finalized Form and Instruction

Information Collection (IC) Details

IC Title:	Evaluation of Mediation Services (Practitioner) - IC for Federal Respondents	Agency IC Tracking Number:	0004 N

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	3320-0004(2)	Mediation Services - Practitioner Questionnaire (Rev 2011)	Mediation Services Practitioner Questionnaire (Rev 2011).pdf	Note: Electronic version of instrument currently being finalized	Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	25	10	15
Annual IC Time Burden (Hours)	8	0	8
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.