Information Collection

NIAMS KAI's Client Survey

IC 201949 under ICR 201112-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NIAMS KAI's Client Survey	Form and Instruction
1 Survey NIAMS Client Survey through Survey Monkey Update 09Apr2012.docx	Form and Instruction
KAI Client Survey fast track template (3) docx-04-04-12.docx KAI Client Survey fast track template (3) docx-04-04-12	IC Document

IC Title:

NIAMS KAI's Client 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
Form and Instruction	1	Survey	NIAMS Client Survey through Survey Monkey Update 09Apr2012.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	29	0	0	0	0	0
Annual IC Time Burden (Hours)	5	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
KAI Client Survey fast track template (3) docx-04-04-12	KAI Client Survey fast track template (3) docx-04-04-12.docx	04/10/2012

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