Information Collection

Generic Clearance for NCA, and IG Customer Satisfaction Surveys (Headstone/Marker)

IC 42215 under ICR 200904-2900-009 · OMB 2900-0571.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0571 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2900-0571 NCA Survey.pdf	Other-Survey

IC Title:

Generic Clearance for NCA, and IG Customer Satisfaction Surveys (Headstone/Marker)

Agency IC Tracking Number:

2900-0571

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
Other-Survey			2900-0571 NCA Survey.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29,650

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	Previously Approved
Annual Number of Responses for this IC	29,650	29,650
Annual IC Time Burden (Hours)	13,325	13,325
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.