Information Collection

Questionnaires

IC 180759 under ICR 201401-0596-001 · OMB 0596-0207.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0207 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS-NRS-1700-1 Questionnaires	Form
FS-NRS-1700-1 NRS Outreach Opportunity Questionnaire 0596-0207 2014 NRS-1700-1 Outreach_Opportunity_Questionnaire v01-24-2014.docx	Form
FS-1700-5 Optional Ethnicity Questionnaire 0596-0207 2014 FS-1700-5 Optional_Ethnicity_Questionnaire v01-24-2014.docx	Form

IC Title:

Questionnaires

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 15

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	FS-NRS-1700-1	NRS Outreach Opportunity Questionnaire	0596-0207 2014 NRS-1700-1 Outreach_Opportunity_Questionnaire v01-24-2014.docx		No		Paper Only
Form	FS-1700-5	Optional Ethnicity Questionnaire	0596-0207 2014 FS-1700-5 Optional_Ethnicity_Questionnaire v01-24-2014.docx		No		Paper Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000,000

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,000,000	922,500	77,500
Annual IC Time Burden (Hours)	33,000	26,542	6,458
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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