Survey of Customer Satisfaction for DCCPS Fellows

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⚠️ Notice: This information collection may be referencing outdated material.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 0925-0642 can be found here:

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.