Information Collection

Survey of Customer Satisfaction for DCCPS Fellows

IC 228535 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⚠️ Notice: This information collection may be referencing outdated material.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 Survey of Customer Satisfaction for DCCPS Fellows	Form
1 Survey Survey (2).docx	Form
Moser Fast Track DCCPS Fellows 10-28-2016 (1).docx Moser Fast Track for DCCPS Fellows	IC Document

IC Title:

Survey of Customer Satisfaction for DCCPS Fellows

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	Survey	Survey (2).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

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	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Moser Fast Track for DCCPS Fellows	Moser Fast Track DCCPS Fellows 10-28-2016 (1).docx	10/02/2017

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