Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

ICR 200302-0915-001

OMB: 0915-0212

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0915-0212 200302-0915-001
Historical Active 200002-0915-004
HHS/HSA
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
Extension without change of a currently approved collection   No
Regular
Approved without change 03/19/2003
Retrieve Notice of Action (NOA) 02/05/2003
The agency is reminded that, under the terms of E.O. 12862, the generic approval of this information collection still require the agency to submit for OMB approval each survey implemented under this clearance. OMB will complete review of the survey within ten working days. The agency is also reminded that, under the terms of E.O. 12862, the agency will use this generic approval solely for customer satisfaction surveys.
  Inventory as of this Action Requested Previously Approved
04/30/2006 04/30/2006 03/31/2003
52,050 0 52,050
5,075 0 5,075
0 0 0

Generic clearance for HRSA to conduct satisfaction surveys in partnership, with states and local governments, health care facilities, health care consortia, health care providers, and researchers. The survey will conduct information on strengths and weaknesses in current services provided by HRSA, to be used to maintain or improve a high quality of services.

None
None


No

1
IC Title Form No. Form Name
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 52,050 52,050 0 0 0 0
Annual Time Burden (Hours) 5,075 5,075 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/05/2003


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