Information Collection

Customer Satisfaction Survey for Evaluation of the 20.88 Single Signature Long-Term Information Sharing Agreement

IC 218969 under ICR 201407-0910-016 · OMB 0910-0360.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
20.88 State and Local Survey Final 0360 11-13-2015.doc	Other-Survey
OMB Justification Memo for Generic Clearance for Customer Satisfaction Survey for Eval of the 20.88 SSLT Agreement 0910-0360 11-12-2015.doc Justification Memo	IC Document
Survey Email Invitation 11-13-2015.doc Email Invitation	IC Document

IC Title:

Customer Satisfaction Survey for Evaluation of the 20.88 Single Signature Long-Term Information Sharing Agreement

Agency IC Tracking Number:

ORA

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			20.88 State and Local Survey Final 0360 11-13-2015.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 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	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification Memo	OMB Justification Memo for Generic Clearance for Customer Satisfaction Survey for Eval of the 20.88 SSLT Agreement 0910-0360 11-12-2015.doc	11/13/2015
Email Invitation	Survey Email Invitation 11-13-2015.doc	11/16/2015

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