Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD

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

Documents and Forms

Document Name Document Type
Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD Form and Instruction
Applicant Interview Guide A2. Interview Guide for Applicants_3 17 2015.docx Form and Instruction
Panelist Interview Guide B2. Interview Guide for Panel Members_3 17 2015.docx Form and Instruction
GenIC ERPOS_3 17 2015.docx ERPOS GenIC Request for Approval IC Document
Applicable Laws or Regulations.docx Authorizing Legislation IC Document
A1. Advance Email for Applicants_3 17 2015.docx Advance Email for Applicants IC Document
B1. Advance Email for Panelists_3 17 2015.docx Advance Email for Panelists IC Document

Information Collection (IC) Details

IC Title:	Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD	Agency IC Tracking Number:	15VH

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	None	Applicant Interview Guide	A2. Interview Guide for Applicants_3 17 2015.docx	None	Yes	No	Paper Only
Form and Instruction	None	Panelist Interview Guide	B2. Interview Guide for Panel Members_3 17 2015.docx	None	Yes	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	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	42	42
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
ERPOS GenIC Request for Approval	GenIC ERPOS_3 17 2015.docx	03/19/2015
Authorizing Legislation	Applicable Laws or Regulations.docx	03/19/2015
Advance Email for Applicants	A1. Advance Email for Applicants_3 17 2015.docx	03/19/2015
Advance Email for Panelists	B1. Advance Email for Panelists_3 17 2015.docx	03/19/2015

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