Information Collection

LRP Ambassador Feedback

IC 224159 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 LRP Ambassador Feedback	Form and Instruction
1 LRP Ambassador Feedback Instrument - LRP Ambassador Feedback.doc	Form and Instruction
LRPAmbassador Feedback Fast Track OMB Form - ML 10-26-2016.doc LRP Ambassador Feedback	IC Document

IC Title:

LRP Ambassador Feedback

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	LRP Ambassador Feedback	Instrument - LRP Ambassador Feedback.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,350

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,350	1,350
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
LRP Ambassador Feedback	LRPAmbassador Feedback Fast Track OMB Form - ML 10-26-2016.doc	10/26/2016

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