Information Collection

Voluntary Customer Surveys to Implement E.O. 12862 in the Public Health Service

IC 7752 under ICR 199706-0937-002 · OMB 0937-0201.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Voluntary Customer Surveys to Implement E.O. 12862 in the Public Health Service

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36,628

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	36,628	21,028	15,600
Annual IC Time Burden (Hours)	4,805	-145	4,950
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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