Information Collection

Bereaved Family Member Satisfaction Survey

IC 45337 under ICR 200609-2900-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-21081(NR) Bereaved Family Member Satisfaction Survey	Form
10-21081(NR) Telephone Bereaved Family Member Satisfaction Survey Bereaved Family Mail Survey.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Form	10-21081(NR)	Telephone Bereaved Family Member Satisfaction Survey	Bereaved Family Mail Survey.doc		No		Paper Only

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,351

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,351	2,351
Annual IC Time Burden (Hours)	588	588
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.