Information Collection

Web site visitors survey

IC 188839 under ICR 200904-0935-002 · OMB 0935-0152.

Documents and Forms

Document Name Document Type
Form Form #4 Web site visitors survey Form and Instruction
Form #4 Web site visitors survey Attachment E -- Web Site Visitors Survey.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Web site visitors survey	Agency IC Tracking Number:

Is this a Common Form? No		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 and Instruction	Form #4	Web site visitors survey	Attachment E -- Web Site Visitors Survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	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.