Information Collection

Center for Polar Medical Operations Physical Qualifications Survey

IC 206967 under ICR 201103-3145-002 · OMB 3145-0215.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0215 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CPMO PQ Survey.pdf	Other-Customer Satisfaction Survey
Post PQ Customer Feedback Survey v1.docx Supporting Statement for Center for Polar Medical Operations Physical Qualifications Survey	IC Document
Demo Email Notification.pdf Email to respondents	IC Document

IC Title:

Center for Polar Medical Operations Physical Qualifications Survey

Agency IC Tracking Number:

IC Status: New

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-Customer Satisfaction Survey			CPMO PQ Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement for Center for Polar Medical Operations Physical Qualifications Survey	Post PQ Customer Feedback Survey v1.docx	05/21/2013
Email to respondents	Demo Email Notification.pdf	05/21/2013

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