Customer Satisfaction Survey for CDC AR Isolate Bank Year 2

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Document Name Document Type
Customer Satisfaction Survey for CDC AR Isolate Bank Year 2 Form
AR Isolate Bank Survey AR Isolate Bank - Customer Satisfaction Survey Items Yr2 v3.docx Form
AR Isolate Bank - Service Delivery Fast Track Template_v4_2017_06_26.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	Customer Satisfaction Survey for CDC AR Isolate Bank Year 2	Agency IC Tracking Number:	0920-1071-17AUB

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	none	AR Isolate Bank Survey	AR Isolate Bank - Customer Satisfaction Survey Items Yr2 v3.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 405	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	405	405
Annual IC Time Burden (Hours)	68	68
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	AR Isolate Bank - Service Delivery Fast Track Template_v4_2017_06_26.docx	06/28/2017

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