Information Collection

ORF Workplace Aesthetic Survey (OD)

IC 229190 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⚠️ Notice: This information collection may be referencing outdated material.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 ORF Workplace Aesthetic Survey (OD)	Form and Instruction
1 NIH Rockledge Visual Vocabulary Survey NIH Rockledge Visual Vocabulary Survey.docx	Form and Instruction
ORF Workplace Aesthetic fast track11.29.17_rev.doc ORF Workplace Aesthetic Survey fast track	IC Document
Visual Vocabulary Survey intro letter.docx Visual Vocabulary Survey Intro Letter	IC Document

IC Title:

ORF Workplace Aesthetic Survey (OD)

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	NIH Rockledge Visual Vocabulary Survey	NIH Rockledge Visual Vocabulary 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: 2,500

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	2,500	2,500
Annual IC Time Burden (Hours)	208	208
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ORF Workplace Aesthetic Survey fast track	ORF Workplace Aesthetic fast track11.29.17_rev.doc	11/29/2017
Visual Vocabulary Survey Intro Letter	Visual Vocabulary Survey intro letter.docx	11/29/2017

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