Agency Stakeholders - ACAS Hard Copy

ATSDR Communication Activities Survey (ACAS)

Documents and Forms

Document Name Document Type
Agency Stakeholders - ACAS Hard Copy Form and Instruction
ATSDR Communication Activities Survey AttF1 Hardcopy ACAS 20201130.docx Form and Instruction
ATSDR Communication Activities Survey AttF1 Hardcopy ACAS 20201130.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Agency Stakeholders - ACAS Hard Copy	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 and Instruction	n/a	ATSDR Communication Activities Survey	AttF1 Hardcopy ACAS 20201130.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26	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	26	26
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	244	244

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.