Information Collection

Customer Satisfaction Surevys - E-mail Services and On-line Ordering

IC 203483 under ICR 201201-0925-004 · OMB 0925-0650.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0650 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 E-mail Services Customer Satisfaction Surevys - E-mail Services and On-line Ordering	Form
Form 2 On-line Ordering Survey Customer Satisfaction Surevys - E-mail Services and On-line Ordering	Form
1 E-mail Services NIMH E-mail Service Customer Satisfaction survey script 7 19 2012 Final.doc	Form
2 On-line Ordering Survey NIMH Publication Ordering Service Customer Satisfaction Survey script 7 19 2012 Final.doc	Form
NIMH Customer Satisfaction Survey-E-mail Service-FS OMB 7 17 12 Final.doc Justification for E-mail Services Collection	IC Document
NIMH Publication Ordering Service Customer Satisfaction Survey script 7 19 2012 Final.doc Justification for On-line Ordering Collection	IC Document

IC Title:

Customer Satisfaction Surevys - E-mail Services and On-line Ordering

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				Yes	Yes	Fillable Printable
Form	2				Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,700

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	1,700	0	0	0	0	0
Annual IC Time Burden (Hours)	142	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
Justification for E-mail Services Collection		07/24/2012
Justification for On-line Ordering Collection		07/24/2012

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

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