Information Collection

NLM Routine Customeer Feedback Collection

IC 203481 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⚠️ Notice: This information collection may be referencing outdated material.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 Routine Customer Feedback Form NLM Routine Customeer Feedback Collection	Form
Form 1B Routine Customer Feedback Form (Screenshots) NLM Routine Customeer Feedback Collection	Form
1 Routine Customer Feedback Form NLM Customer Service Satisfaction Survey 2012 7.2012 FINAL.doc	Form
1B Routine Customer Feedback Form (Screenshots) NLM Email_Web Customer Service Screenshots 7.2012 FINAL.pdf	Form
NLM CUSTOMER SERVICE _NIH_fast_track_request 7.2012 FINAL.doc NLM Routine Feedback Survey Justification	IC Document
Survey invite 7.2012 FINAL.doc Survey Invite Text	IC Document

IC Title:

NLM Routine Customeer Feedback Collection

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	1	Routine Customer Feedback Form	NLM Customer Service Satisfaction Survey 2012 7.2012 FINAL.doc		Yes	Yes	Fillable Printable
Form	1B	Routine Customer Feedback Form (Screenshots)	NLM Email_Web Customer Service Screenshots 7.2012 FINAL.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	500	0	0	0	0	0
Annual IC Time Burden (Hours)	42	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
NLM Routine Feedback Survey Justification	NLM CUSTOMER SERVICE _NIH_fast_track_request 7.2012 FINAL.doc	07/24/2012
Survey Invite Text	Survey invite 7.2012 FINAL.doc	07/24/2012

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