NLM Routine Customeer Feedback Collection

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 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

Information Collection (IC) Details

IC Title:	NLM Routine Customeer Feedback Collection	Agency IC Tracking Number:

IC Status: New

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	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 %

	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

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.