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Customer Survey - Ind / Households
Child Welfare Information Gateway
OMB: 0970-0303
IC ID: 43726
OMB.report
HHS/ACF
OMB 0970-0303
ICR 201008-0970-001
IC 43726
( )
Documents and Forms
Document Name
Document Type
Form 0970-0303
Customer Survey - Ind / Households
Form
0970-0303 Appendix B_Customer Survey
Appendix B_Customer Survey.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Customer Survey - Ind / Households
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
0970-0303
Appendix B_Customer Survey
Appendix B_Customer Survey.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
846
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
76 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
846
0
-362
0
0
1,208
Annual IC Time Burden (Hours)
66
0
-28
0
0
94
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
