Information Collection

e-Communications Recipient

IC 197113 under ICR 201403-0930-006 · OMB 0930-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0325 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Customer Satisfact e-Communications Recipient	Form and Instruction
Customer Satisfact Customer Satisfaction Survey Attachment B1 Customer Satisfaction Survey.docx	Form and Instruction

IC Title:

e-Communications Recipient

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	Customer Satisfaction Survey	Customer Satisfaction Survey	Attachment B1 Customer Satisfaction Survey.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	300	50	250
Annual IC Time Burden (Hours)	75	12	63
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.