Grants to States Extranet Survey

Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3137-0081 can be found here:

Documents and Forms

Document Name Document Type
Form Extranet Survey 1 Grants to States Extranet Survey Form and Instruction
Extranet Survey 1 Extranet Survey Extranet Survey.pdf form.jotform.us/form/41524091197151 Form and Instruction
Email Attachments - Extranet Survey May 2014_final.docx Email to Survey Participants IC Document
Grants to States Generic Clearance Document 05 28 14.docx Request for Approval under the Generic Clearance for the Collection of Routine Customer Feedback IC Document
Reporting Burden Estimate.xls Extranet Survey Reporting Burden spreadsheet IC Document

Information Collection (IC) Details

IC Title:	Grants to States Extranet 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
Form and Instruction	Extranet Survey 1	Extranet Survey	Extranet Survey.pdf	http://form.jotform.us/form/41524091197151	Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Cultural and Historic Preservation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 221	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	221	221
Annual IC Time Burden (Hours)	55	55
Annual IC Cost Burden (Dollars)	1,859	1,859

Documents for IC

Title	Document	Date Uploaded
Email to Survey Participants	Email Attachments - Extranet Survey May 2014_final.docx	07/11/2014
Request for Approval under the Generic Clearance for the Collection of Routine Customer Feedback	Grants to States Generic Clearance Document 05 28 14.docx	07/11/2014
Extranet Survey Reporting Burden spreadsheet	Reporting Burden Estimate.xls	07/11/2014

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