Learn the Signs. Act Early Bulk Orders

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

OMB: 0920-0919

IC ID: 223249

Documents and Forms
Document Name
Document Type
Other-WORD
Other-Screenshots
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Learn the Signs. Act Early Bulk Orders 16BAY
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att1 Bulk Order Survey_tjj.docx Yes Yes Paper Only
Other-Screenshots Att3.Screen Shots of Bulk Order Survey_tjj.docx Yes Yes Fillable Fileable

Health Health Care Services

 

3,240 0
   
Private Sector Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,240 0 3,240 0 0 0
Annual IC Time Burden (Hours) 270 0 270 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval/SupSta A Sup Sta A_ LTSAE Bulk Orders REVISED_CJP8-28-16_clean.docx 08/29/2016
SupSta B Sup_Sta Part_B_for_BULK_ORDERS REVISED_ CJP8-28-16_clean.docx 08/29/2016
Att 2_Survey Invitation Email Att2.Survey Invitation Email for Bulk Orders.docx 08/29/2016
Att 4_Social Media or 3rd Party Site Security Survey/Plan Att4.Survey Monkey 3rd party SSP for Bulk Orders of Survey.pdf 08/29/2016
Att 5_ IRB_Non-research Att5.Bulk Order IRB Non-Research Determination.pdf 08/29/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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