Information Collection

DVR Cutomer Service Survey - Animal Services

IC 226134 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⚠️ Notice: This information collection may be referencing outdated material.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 DVR Cutomer Service Survey - Animal Services	Form
1 Animal Services Survey 031717-FINAL-FY17 Animal Services Survey.docx	Form
031717-FINAL-PRA-Letter-DVR Animal Services Survey (2).docx PRA Letter DVR Animal Services	IC Document
031717-FINAL-Animal Services Request for OMB Survey Approval.docx Animal Services Fast track template	IC Document

IC Title:

DVR Cutomer Service Survey - Animal Services

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	1	Animal Services Survey	031717-FINAL-FY17 Animal Services Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

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	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PRA Letter DVR Animal Services	031717-FINAL-PRA-Letter-DVR Animal Services Survey (2).docx	03/20/2017
Animal Services Fast track template	031717-FINAL-Animal Services Request for OMB Survey Approval.docx	04/06/2017

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