Information Collection

EDN User Assessment

IC 229376 under ICR 201503-0920-011 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EDN User Assessment	Form
EDN User Survey - screenshots Att 1 - Final Survey Screenshots.docx	Form
EDN User Survey - word EDN User Assessment_finalsurvey.pdf	Form
Service Delivery Fast Track Template_EDNUserAssessment_12.5.docx Request for Approval	IC Document
Att 2 - Email notifications.docx Email notifications	IC Document
Att 3 - Non-researech determination.pdf Non-research determination	IC Document

IC Title:

EDN User Assessment

Agency IC Tracking Number:

0920-1071-18IF

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	none	EDN User Survey - screenshots	Att 1 - Final Survey Screenshots.docx		Yes	Yes	Fillable Fileable
Form	none	EDN User Survey - word	EDN User Assessment_finalsurvey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,003

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	1,003	1,003
Annual IC Time Burden (Hours)	251	251
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Service Delivery Fast Track Template_EDNUserAssessment_12.5.docx	12/06/2017
Email notifications	Att 2 - Email notifications.docx	12/06/2017
Non-research determination	Att 3 - Non-researech determination.pdf	12/06/2017

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