Customer Surveys Generic Clearance for the National Center for Health Statistics

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Web User Survey	Form	Unchanged	Available
Aging Forum Data User Questions	Form and Instruction	Unchanged	Available
Children’s Forum Data User Survey Questions	Form and Instruction	Unchanged	Available
Form 0920-0729 Att G Student Eval Form	Form and Instruction	Unchanged	Available
Form 0920-0729 Att F Parent Eval Form	Form and Instruction	Unchanged	Available
Form 0920-0729 Att E Registration Form	Form and Instruction	Unchanged	Available
Form 0920-0729 Att D Teacher Form	Form and Instruction	Unchanged	Available
Form 0920-0729 Att C Student App	Form and Instruction	Unchanged	Available
Form 0920-0729 Att B Parent App	Form and Instruction	Unchanged	Available
Children and Aging Forums Feedback Survey	Form	Unchanged	Available
Form 0920-0729 Attachment A Feedback Survey	Form and Instruction	Unchanged	Available
NCHS Website User Customer Satisfaction Survey Questions	Form and Instruction	Unchanged	Available
Customer Satisfaction Website Survey	Form	Unchanged	Source copy available
NCHS Feedback Survey	Form	Unchanged	Available
0920-0729 Change Request 100516.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-10-06	Available
Attachment B 60-day FRN 112513.pdf	Supplementary Document	Uploaded 2014-03-31	Available
Attachment C 0920-0729 Human Subjects Memo.pdf	Supplementary Document	Uploaded 2014-03-31	Available
Attachment A Leg NCHS 2014-2016.docx	Supplementary Document	Uploaded 2014-03-31	Available
Sup State B NCHS 2014-2016 customer survey 031914.docx	Supporting Statement B	Uploaded 2014-03-31	Available
Sup State A NCHS 2014-2016 customer survey 051314.docx	Supporting Statement A	Uploaded 2014-05-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223066	NCHS Website Users Customer Satisfaction Survey	Form	Unchanged	Web User Survey
221432	Children's and Aging Forums Data User Surveys	Form and Instruction	Unchanged	Aging Forum Data User Questions
221432	Children's and Aging Forums Data User Surveys	Form and Instruction	Unchanged	Children’s Forum Data User Survey Questions
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att G Student Eval Form
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att F Parent Eval Form
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att E Registration Form
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att D Teacher Form
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att C Student App
220313	The NCHS Data Detective Camp	Form and Instruction	Unchanged	Att B Parent App
217816	Children and Aging Forums Feedback Survey	Form	Unchanged	Children and Aging Forums Feedback Survey
217691	Feedback Survey of persons registered for the NCHS 2015 National Conference on Health Statistics	Form and Instruction	Unchanged	Attachment A Feedback Survey
213459	NCHS Website Users Customer Satisfaction Survey	Form and Instruction	Unchanged	NCHS Website User Customer Satisfaction Survey Questions
203875	Customer Satisfaction Survey for the Research Data Center	Other-WORD	Unchanged
198394	Feedback Survey of Persons registered for the NCHS 2010 National Conference	Form	Unchanged	Customer Satisfaction Website Survey
198394	Feedback Survey of Persons registered for the NCHS 2010 National Conference	Form	Unchanged	NCHS Feedback Survey

ICR Details

OMB Control No: 0920-0729	ICR Reference No: 201610-0920-002
Status: Historical Active	Previous ICR Reference No: 201403-0920-018
Agency/Subagency: HHS/CDC	Agency Tracking No: 17AJ
Title: Customer Surveys Generic Clearance for the National Center for Health Statistics
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/24/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/06/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	05/31/2017	05/31/2017
Responses	12,540	0	10,440
Time Burden (Hours)	2,440	0	2,040
Cost Burden (Dollars)	0	0	0

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Abstract: NCHS surveys its customers' satisfaction with the quality and relevance of the information it produces. NCHS conducts voluntary customer surveys to assess strengths in agency products and services. Results are used for planning initiatives. Request for change to add burden hours.

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Authorizing Statute(s): US Code: 42 USC 242 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 70302	11/25/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 19087	04/07/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Children and Aging Forums Feedback Survey	none	Children and Aging Forums Feedback Survey
Children's and Aging Forums Data User Surveys	NA, NA	Children’s Forum Data User Survey Questions ,   Aging Forum Data User Questions
Customer Satisfaction Survey for the Research Data Center
Feedback Survey of Persons registered for the NCHS 2010 National Conference	none, none	NCHS Feedback Survey ,   Customer Satisfaction Website Survey
Feedback Survey of persons registered for the NCHS 2015 National Conference on Health Statistics	0920-0729	Attachment A Feedback Survey
NCHS Website Users Customer Satisfaction Survey	None	NCHS Website User Customer Satisfaction Survey Questions
NCHS Website Users Customer Satisfaction Survey	none	Web User Survey
The NCHS Data Detective Camp	0920-0729, 0920-0729, 0920-0729, 0920-0729, 0920-0729, 0920-0729	Att B Parent App ,   Att C Student App ,   Att D Teacher Form ,   Att E Registration Form ,   Att F Parent Eval Form ,   Att G Student Eval Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	12,540	10,440	0	0	2,100	0
Annual Time Burden (Hours)	2,440	2,040	0	0	400	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Request for change to add respondents and burden hours to this generic clearance.

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Annual Cost to Federal Government: $100,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/06/2016

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