CDC GIS Day Stakeholder Registration and Feedback

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⚠️ Notice: This information collection may be referencing outdated material.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 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
CDC GIS Day Stakeholder Registration and Feedback Form
Registration and Feedback Attachment A1 - Stakeholder Registration and Feedback Form (screenshots).docx Form
Where in the World quiz Attachment B1 - Where in the World Quiz (screenshots).docx Form
CDC GIS Day Stakeholder Registration and Feedback.pdf Request for Approval IC Document
Attachment C - Recruitment Email.docx Recruitment Email IC Document

Information Collection (IC) Details

IC Title:	CDC GIS Day Stakeholder Registration and Feedback	Agency IC Tracking Number:	0923-0047-17BAL

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	Registration and Feedback	Attachment A1 - Stakeholder Registration and Feedback Form (screenshots).docx		Yes	Yes	Fillable Fileable
Form	none	Where in the World quiz	Attachment B1 - Where in the World Quiz (screenshots).docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	CDC GIS Day Stakeholder Registration and Feedback.pdf	08/30/2017
Recruitment Email	Attachment C - Recruitment Email.docx	08/30/2017

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