IHS Customer Satisfaction Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OEHE Supporting Statement-revbg 12-01-2009-final.docm	Supporting Statement B	Uploaded 2010-02-02	Available
30 day notice CUSTOMERSS 1-25-10.pdf	Supplementary Document	Uploaded 2010-02-02	Available
PostConstructionOMSurvey10292009.doc	Supplementary Document	Uploaded 2009-11-06	Available
AnnualOperatorOMSurvey10292009.doc	Supplementary Document	Uploaded 2009-11-06	Available
TribalPartnerSurvey10292009.doc	Supplementary Document	Uploaded 2009-11-06	Available
TribalHomeownerSurvey10292009.doc	Supplementary Document	Uploaded 2009-11-06	Available
OEHE Supporting Statement-revbg 12-01-2009-final.docm	Supporting Statement A	Uploaded 2010-02-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192426	Post Construction O&M Survey		New
192425	Annual Operator O&M Survey		New
192424	Tribal Partner Survey		New
192423	Tribal Homeowner Survey		New

ICR Details

OMB Control No: 0917-0035	ICR Reference No: 201004-0917-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/IHS	Agency Tracking No:
Title: IHS Customer Satisfaction Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2010
	Date Received in OIRA: 04/05/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2013	36 Months From Approved
Responses	1,800	0	0
Time Burden (Hours)	90	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The IHS goal is to raise the health status of the American Indian and Alaska Native people to the highest possible level by providing comprehensive health care and preventive health services. To support the IHS mission, the SFCP provides technical and financial assistance to American Indian Tribes and Alaska Native villages for cooperative development and continued operation of safe water, wastewater, and solid waste systems and related support facilities. The IHS Office of Environmental Health and Engineering(OEHE), Sanitation Facilities Construction Branch (SFCB), "Customer Satisfaction Surveys", will provide the information needed to complete these goals. With the information collected from tribal homeowners, Tribal leaders, and Tribal operation and maintenance operators, the SFCP will make improvements that will result in improved quality of services.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standars
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 46201	09/08/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 3906	01/25/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Annual Operator O&M Survey
Post Construction O&M Survey
Tribal Homeowner Survey
Tribal Partner Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,800	0	0	1,800	0	0
Annual Time Burden (Hours)	90	0	0	90	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection

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Annual Cost to Federal Government: $4,500

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/05/2010

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