Information Collection

DVR Animal Services Needs Assessment

IC 230048 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⚠️ Notice: This information collection may be referencing outdated material.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 Animal Services Needs Assessment	Form
1 DVR Needs Assessment Survey 020518-FY18-DRAFT DVR Needs Assessment Survey.docx	Form
020218-FY18-DVR Survey Request for OMB Survey Approval_kc.docx FY18 DVR Survey Request	IC Document

IC Title:

DVR Animal Services Needs Assessment

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	DVR Needs Assessment Survey	020518-FY18-DRAFT DVR Needs Assessment 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: 10

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	10	10
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
FY18 DVR Survey Request	020218-FY18-DVR Survey Request for OMB Survey Approval_kc.docx	02/12/2018

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