Customer feedback interviews with state-level implementers of "Return to Learn"

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1009 can be found here:

Documents and Forms

Document Name Document Type
Instrument_GenIC_TBI_RTL022516.docx Other-WORD
Att A_Invitation Email_GenIC_TBI_RTL.docx Invitation Email IC Document
Request_GenIC_1009_TBI_RTL_022516.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Customer feedback interviews with state-level implementers of "Return to Learn"	Agency IC Tracking Number:	16UK

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
Other-WORD			Instrument_GenIC_TBI_RTL022516.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Invitation Email	Att A_Invitation Email_GenIC_TBI_RTL.docx	03/09/2016
Request for Approval	Request_GenIC_1009_TBI_RTL_022516.docx	03/09/2016

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