Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (HITRC)

ICR 201408-0955-001

OMB: 0955-0003

Federal Form Document

Forms and Documents
ICR Details
0955-0003 201408-0955-001
Historical Active 201208-0955-003
HHS/ONC
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (HITRC)
Extension without change of a currently approved collection   No
Regular
Approved without change 12/03/2014
Retrieve Notice of Action (NOA) 10/29/2014
OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.
  Inventory as of this Action Requested Previously Approved
12/31/2017 36 Months From Approved 12/31/2014
4,158 0 4,158
1,041 0 1,041
0 0 0

This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None

Not associated with rulemaking

  79 FR 46441 08/08/2014
79 FR 64195 10/28/2014
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,158 4,158 0 0 0 0
Annual Time Burden (Hours) 1,041 1,041 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$93,687
No
No
No
No
No
Uncollected
Sherrette Funn-Coleman 2026905683

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/29/2014


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