Information Collection

Voluntary Customer Surveys Generic Clearance for the Agency for Healthcare Research and Quality

IC 37873 under ICR 200603-0935-001 · OMB 0935-0106.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Voluntary Customer Surveys Generic Clearance for the Agency for Healthcare Research and Quality	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: 103,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Previously Approved
Annual Number of Responses for this IC	103,400	103,400
Annual IC Time Burden (Hours)	16,356	16,356
Annual IC Cost Burden (Dollars)	515,732,000	515,732,000

Documents for IC

Title	Document	Date Uploaded

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