OMB No. 0917-0036, Sugar Shockers Health Campaign Survey, Catawba Service Unit

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Document Name Document Type
Form 0917-0036 OMB No. 0917-0036, Sugar Shockers Health Campaign Survey, Catawba Service Unit Form and Instruction
0917-0036 Sugar Shockers Health Campaign Survey, at Catawaba, SU OMB 0917-0036 Sugar Shocker Health Campaign Survey at Catawaba SU.docx Form and Instruction
0917-0036- Mini-Supporting Statement for Sugar Shocker Health Campaign Survey at Catawaba SU.doc 0MB No. 0917-0036, Mini-supporting Statement forSugar Shockers Health Campaign Survey, at Catawaba SU IC Document

Information Collection (IC) Details

IC Title:	OMB No. 0917-0036, Sugar Shockers Health Campaign Survey, Catawba Service Unit	Agency IC Tracking Number:	)MB-0917-0036-49

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 and Instruction	0917-0036	Sugar Shockers Health Campaign Survey, at Catawaba, SU	OMB 0917-0036 Sugar Shocker Health Campaign Survey at Catawaba SU.docx		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0MB No. 0917-0036, Mini-supporting Statement forSugar Shockers Health Campaign Survey, at Catawaba SU	0917-0036- Mini-Supporting Statement for Sugar Shocker Health Campaign Survey at Catawaba SU.doc	03/02/2015

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