Information Collection

CWT IT Consumers Satisfaction Survey_1

IC 223597 under ICR 201403-2900-007 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CWT IT Consumers Satisfaction Survey.doc	Other-Survey
PRA Satisfaction Survey Approval Request - CWT IT Consumers.docx CWT IT Consumers Generic Request	IC Document

IC Title:

CWT IT Consumers Satisfaction Survey_1

Agency IC Tracking Number:

2900-0770

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
Other-Survey			CWT IT Consumers Satisfaction Survey.doc		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CWT IT Consumers Generic Request	PRA Satisfaction Survey Approval Request - CWT IT Consumers.docx	11/02/2016

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