Information Collection

NCEF Survey for Program Operations

IC 227333 under ICR 201702-0925-001 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 NCEF Survey for Program Operations	Form
1 Customer Survey Customer Survey.docx	Form
NCEF Fast Track.docx NCEF Fast Track template	IC Document
Email text NCEF Survey20170620.pdf Email text NCEF survey	IC Document

IC Title:

NCEF Survey for Program Operations

Agency IC Tracking Number:

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	1	Customer Survey	Customer Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	120	120
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NCEF Fast Track template	NCEF Fast Track.docx	06/29/2017
Email text NCEF survey	Email text NCEF Survey20170620.pdf	06/29/2017

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