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.

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Information Collection (IC) Details

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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:

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 %

	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

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