Institute Feedback Form

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Institute Feedback Form Form and Instruction
1 Institute Feedback Form Institute Feedback Form - INSTRUMENT-5-10-17.docx Form and Instruction
Institute Feedback Form-fast-track-PRA-submission-short-form-5-10-17.pdf Jusification IC Document

Information Collection (IC) Details

IC Title:	Institute Feedback Form	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Institute Feedback Form	Institute Feedback Form - INSTRUMENT-5-10-17.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Jusification	Institute Feedback Form-fast-track-PRA-submission-short-form-5-10-17.pdf	05/10/2017

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