Participant Feedback at ATSDR-organized conference session

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⚠️ Notice: This information collection may be referencing outdated material.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 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
Participant Feedback at ATSDR-organized conference session Form and Instruction
Group discussion guide AppndxB GenIC Smll Grp Discussion Leader Guide v2.docx Form and Instruction
GenIC Prtcpnt feedbck ATSDR-orgnzd confrnc session v2 sgnd OS.pdf Request for Approval IC Document
AppndxA GenIC Prtcpnt feedbck ATSDR-orgnzd confrnc session abstrct.doc Conference Session Abstract IC Document

Information Collection (IC) Details

IC Title:	Participant Feedback at ATSDR-organized conference session	Agency IC Tracking Number:	15AQP

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	none	Group discussion guide	AppndxB GenIC Smll Grp Discussion Leader Guide v2.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	GenIC Prtcpnt feedbck ATSDR-orgnzd confrnc session v2 sgnd OS.pdf	06/17/2015
Conference Session Abstract	AppndxA GenIC Prtcpnt feedbck ATSDR-orgnzd confrnc session abstrct.doc	06/17/2015

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