OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

NICHD Safe to Sleep® Campaign High-Risk States Outreach Program Customer Satisfaction Survey

IC 214906 under ICR 201410-0925-002 · OMB 0925-0643.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

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NICHD Safe to Sleep® Campaign High-Risk States Outreach Program Customer Satisfaction Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 High-risk States Outreach Program Customer Satisfaction Survey 0925-0643_High-risk States Outreach Program Customer Satisfaction Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

70 0
   
State, Local, and Tribal Governments
 
   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 70 0 70 0 0 0
Annual IC Time Burden (Hours) 12 0 12 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Fast-Track template High-risk States Outreach Program Customer Satisfaction Survey 0925-0643_Fast Track_High-Risk States Customer Satisfaction Survey_11-26-14_FINAL-1.doc 02/05/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.