Information Collection

Sub-study #8_HD*Calc Customer Satisfaction Survey for Private Sector Respondents

IC 201596 under ICR 201108-0925-002 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Sub-study #8_HD*Calc Customer Satisfaction Survey for Private Sector Respondents	Form and Instruction
1 Full Survey with Skips _8_Attach_2_Full_Survey_with_identified_skips_HD_Calc[1].docx	Form and Instruction
#8_Fast-Track_Request_Private_HD Calc.doc #8_Fast-Track_Request_Private_HD Calc	IC Document
#8_Attach 3_Email Invite_HD Calc.doc #8_Attach 3_Email Invite_HD Calc	IC Document
_8_Attach_1_Survey_Screenshots_HD_Calc[1].pptx Screen shots	IC Document

IC Title:

Sub-study #8_HD*Calc Customer Satisfaction Survey for Private Sector Respondents

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
Form and Instruction	1	Full Survey with Skips	_8_Attach_2_Full_Survey_with_identified_skips_HD_Calc[1].docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	19	19
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
#8_Fast-Track_Request_Private_HD Calc	#8_Fast-Track_Request_Private_HD Calc.doc	03/15/2012
#8_Attach 3_Email Invite_HD Calc	#8_Attach 3_Email Invite_HD Calc.doc	03/16/2012
Screen shots	_8_Attach_1_Survey_Screenshots_HD_Calc[1].pptx	03/22/2012

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