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

Customer/Partner Service Surveys

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.