StopAnthrax Test Messaging Program Jurisdictional Pilot Test-User Satisfaction Feedback Collection

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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
StopAnthrax Test Messaging Program Jurisdictional Pilot Test-User Satisfaction Feedback Collection Form
Survey Att2-ParPilotSurv2.docx Form
Focus group guide Att3-JurPilSurv2.docx Form and Instruction
Enrollment Att1a-Enrollmentv2.docx Form
FINAL_StopAnthrax Jurisdictional Pilot Test-Information Collection Procedures_042616.docx Information Collection Procedures IC Document
StopAnthrax Pilot Test Briefing Slides.pptx Program Briefing Presentation IC Document
Att1-Posters.pdf Posters IC Document
Att1b-PilTest.pdf Testing Flowchart IC Document
0920-1050-OPHPR-StopAnthrax Pilot Test Feedback-Approval Request.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	StopAnthrax Test Messaging Program Jurisdictional Pilot Test-User Satisfaction Feedback Collection	Agency IC Tracking Number:	16AIB

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Survey	Att2-ParPilotSurv2.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Focus group guide	Att3-JurPilSurv2.docx	Yes	Yes	Fillable Fileable
Form	none	Enrollment	Att1a-Enrollmentv2.docx	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	700	700
Annual IC Time Burden (Hours)	700	700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Information Collection Procedures	FINAL_StopAnthrax Jurisdictional Pilot Test-Information Collection Procedures_042616.docx	05/04/2016
Program Briefing Presentation	StopAnthrax Pilot Test Briefing Slides.pptx	05/04/2016
Posters	Att1-Posters.pdf	05/04/2016
Testing Flowchart	Att1b-PilTest.pdf	05/04/2016
Request for Approval	0920-1050-OPHPR-StopAnthrax Pilot Test Feedback-Approval Request.docx	05/04/2016

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