Information Collection

NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents

IC 6995 under ICR 200903-0920-001 · OMB 0920-0544.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0544 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form No number NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents	Form
No number NIOSH Customer Satisfaction Survey Attachment E NIOSH CSS_2008_06_04_Qs from baseline vs new.doc	Form
Attachment C1 NIOSH CUSTOMER SATISFACTION SURVEY_2008_06_17.doc Attachment C - Previous survey	IC Document
Attachment C8 Survey Instructions.doc Attachment C8 - Survey Instructions	IC Document

IC Title:

NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	No number	NIOSH Customer Satisfaction Survey	Attachment E NIOSH CSS_2008_06_04_Qs from baseline vs new.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 570

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 12 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	570	-30	600
Annual IC Time Burden (Hours)	190	-10	200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment C - Previous survey	Attachment C1 NIOSH CUSTOMER SATISFACTION SURVEY_2008_06_17.doc	01/28/2009
Attachment C8 - Survey Instructions	Attachment C8 Survey Instructions.doc	01/28/2009

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