Information Collection

NCHS Website Users Customer Satisfaction Survey

IC 223066 under ICR 201403-0920-018 · OMB 0920-0729.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0729 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NCHS Website Users Customer Satisfaction Survey	Form
Web User Survey Att B Web User Survey_2016 081716.docx	Form
Sup St B 072716.docx Supporting Statement B	IC Document
Sup St A 081716.doc Supporting Statement A	IC Document
Att A Web User Survey_2016 with changes 081716.docx Survey with track changes	IC Document

IC Title:

NCHS Website Users Customer Satisfaction Survey

Agency IC Tracking Number:

16BAG

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	none	Web User Survey	Att B Web User Survey_2016 081716.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement B	Sup St B 072716.docx	08/17/2016
Supporting Statement A	Sup St A 081716.doc	08/17/2016
Survey with track changes	Att A Web User Survey_2016 with changes 081716.docx	08/17/2016

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