AppendixG_NoticeofOMBAction

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

09/08/2015

Department of Health and Human Services
National Institutes of Health
FOR CERTIFYING OFFICIAL:

Franklin Baitman

FOR CLEARANCE OFFICER:

Darius Taylor

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
09/04/2015
ACTION REQUESTED:

Generic IC

TYPE OF REVIEW REQUESTED:
ICR REFERENCE NUMBER:

201503-0925-004

AGENCY ICR TRACKING NUMBER:
TITLE:

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

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

0925-0653

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE:

DISCONTINUE DATE:

BURDEN:

RESPONSES

HOURS

COSTS

Previous

4,425

3,075

0

New

4,425

3,075

0

Change due to New Statute

0

0

0

Change due to Agency Discretion

0

0

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference

TERMS OF CLEARANCE:

Terms of the Generic ICR remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Acting Deputy Administrator,
Office Of Information And Regulatory Affairs

IC Title

Form No.

List of ICs
Form Name

CFR Citation

Individual interviews to 1, 2
Appendix A
solicit feedback on
InterviewRecruitment,
family-focused materials
Appendix C
developed for a
InterviewInstrument
pediatric palliative care
communications
campaign
Total Hours Actually Used for Information Collections Under Currently Approved ICR:

Hrs/$/Resp
16 / 0 / 36

16