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Corps Community Day Event Forms
Corps Community Month Event Form
OMB: 0915-0362
IC ID: 206735
OMB.report
HHS/HSA
OMB 0915-0362
ICR 201605-0915-004
IC 206735
( )
Documents and Forms
Document Name
Document Type
Form 1
Corps Community Day Event Forms
Form
1 Event Planning Form
Corps Community Month Pre Event Instrument.docx
Form
2 Satisfaction Form
Corps Community Month Post Event Instrument.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Corps Community Day Event Forms
Agency IC Tracking Number:
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
1
Event Planning Form
Corps Community Month Pre Event Instrument.docx
Yes
Yes
Fillable Fileable
Form
2
Satisfaction Form
Corps Community Month Post Event Instrument.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
150
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
600
0
0
0
0
600
Annual IC Time Burden (Hours)
30
0
0
0
0
30
Annual IC Cost Burden (Dollars)
0
0
0
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.