Voluntary Customer Feedback Survey: Foodborne Illness Outbreak Investigation

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0151 can be found here:

Documents and Forms

Document Name Document Type
OPHS Voluntary Customer Feedback Survey 022017.docx Other-OPHS Voluntary Customer Feedba
FSIS OPHS AES_Generic Clearance Certification Page_2.6.17.docx Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” IC Document

Information Collection (IC) Details

IC Title:	Voluntary Customer Feedback Survey: Foodborne Illness Outbreak Investigation	Agency IC Tracking Number:

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-OPHS Voluntary Customer Feedback Survey			OPHS Voluntary Customer Feedback Survey 022017.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	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	120	120
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”	FSIS OPHS AES_Generic Clearance Certification Page_2.6.17.docx	02/06/2017

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