WISQARS Home Page Survey

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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1009 can be found here:

Documents and Forms

Document Name Document Type
WISQARS Home Page Survey.docx Other-WORD
WISQARS Home Page Survey - Screenshots - 6-21-2014.pdf Other-Screenshots
WISQARS Home Page Survey - GenIC Request.docx WISQARS Home Page Survey GenIC Request IC Document

Information Collection (IC) Details

IC Title:	WISQARS Home Page Survey	Agency IC Tracking Number:

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
Other-WORD			WISQARS Home Page Survey.docx		Yes	Yes	Fillable Printable
Other-Screenshots			WISQARS Home Page Survey - Screenshots - 6-21-2014.pdf		No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
WISQARS Home Page Survey GenIC Request	WISQARS Home Page Survey - GenIC Request.docx	06/23/2014

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