Information Collection

User Feedback Questionnaire for ERHMS Info Manager

IC 222175 under ICR 201505-0920-003 · OMB 0920-0953.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Questionnaire for User Demonstration.docx	Other-WORD
OMB Approval for ERHMS Info Manager Feedback Questionnaire.docx Request for Approval	IC Document

IC Title:

User Feedback Questionnaire for ERHMS Info Manager

Agency IC Tracking Number:

16ASP

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
Other-WORD			Questionnaire for User Demonstration.docx		No		Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 65

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	65	65
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	OMB Approval for ERHMS Info Manager Feedback Questionnaire.docx	06/24/2016

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