Information Collection

NCTN Satisfaction Survey

IC 224442 under ICR 201406-0925-004 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NCTN Satisfaction Survey	Form
1 NCTN Survey Screenshots NCTN Survey Screenshots - 11-16-16.docx	Form
Fast Track NCTN.docx Fast track NCTN Customer Feedback	IC Document
NCTN Survey Email Invite - 11-16-16.docx NCTN Survey Email Invite	IC Document

IC Title:

NCTN Satisfaction Survey

Agency IC Tracking Number:

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	1	NCTN Survey Screenshots	NCTN Survey Screenshots - 11-16-16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,100

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	1,100	1,100
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track NCTN Customer Feedback	Fast Track NCTN.docx	11/16/2016
NCTN Survey Email Invite	NCTN Survey Email Invite - 11-16-16.docx	11/16/2016

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