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CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient
American Customer Satisfaction Index
OMB: 1505-0191
IC ID: 186197
OMB.report
TREAS/DO
OMB 1505-0191
ICR 200707-1505-001
IC 186197
( )
Documents and Forms
Document Name
Document Type
Form CFI 175
CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient
Form
CFI 175 ED NCES questionnaire
CFI 175 ED NCES.doc
Form
CFI 176 DOT FAA ATO questionnaire
CFI 176 DOT FAA ATO.doc
Form
CFI 177 DOD Tricare Outpatient questionnaire
CFI 177 DOD Tricare Outpatient.doc
Form
CFI 178 DOD Tricare Inpatient
CFI 178 DOD Tricare Inpatient.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient
Agency IC Tracking Number:
CFI 175, CFI 176, CFI 177, CFI 178
IC Status:
New
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
Form
CFI 175
ED NCES questionnaire
CFI 175 ED NCES.doc
Yes
Yes
Fillable Fileable
Form
CFI 176
DOT FAA ATO questionnaire
CFI 176 DOT FAA ATO.doc
Yes
Yes
Fillable Fileable
Form
CFI 177
DOD Tricare Outpatient questionnaire
CFI 177 DOD Tricare Outpatient.doc
No
Paper Only
Form
CFI 178
DOD Tricare Inpatient
CFI 178 DOD Tricare Inpatient.doc
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,040
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,040
0
0
0
0
0
Annual IC Time Burden (Hours)
208
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.