Information Collection

FSR 247 DOD Air Force, FSR 248 HHS CMS FCSO J9 MAC, FSR 249 CitizenFeedback

IC 188008 under ICR 200807-1505-001 · OMB 1505-0186.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FSR 247 FSR 247 DOD Air Force, FSR 248 HHS CMS FCSO J9 MAC, FSR 249 CitizenFeedback	Form
FSR 247 DOD Air Force questionnaire FSR 247 DOD Air Force.xls	Form
FSR 248 HHS CMS FCSO J9 MAC questionnaire FSR 248 HHS CMS FCSO J9 MAC.xls	Form
FSR 249 Citizen Feedback Questionnaire FSR 249 CitizenFeedback Questionaire.xls	Form
Justification for ICs to generic ICR 1505-0186.doc Justification for ICs to generic ICR 1505-0186	IC Document

IC Title:

Agency IC Tracking Number:

FSR 247, FSR 248, FSR 249

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSR 247	DOD Air Force questionnaire	FSR 247 DOD Air Force.xls	Yes	Yes	Fillable Fileable
Form	FSR 248	HHS CMS FCSO J9 MAC questionnaire	FSR 248 HHS CMS FCSO J9 MAC.xls	Yes	Yes	Fillable Fileable
Form	FSR 249	Citizen Feedback Questionnaire	FSR 249 CitizenFeedback Questionaire.xls	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for ICs to generic ICR 1505-0186	Justification for ICs to generic ICR 1505-0186.doc	02/20/2009

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