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CTSU Multi-Group Audit (MGA) Feedback Surveys
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0925-0642
IC ID: 230057
OMB.report
HHS/NIH
OMB 0925-0642
ICR 201702-0925-001
IC 230057
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:
2023-01-30 - Extension without change of a currently approved collection
2020-02-19 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
CTSU Multi-Group Audit (MGA) Feedback Surveys
Form
1 MGA Feedback Survey AUDIT Staff screenshots
MGA Feedback Survey AUDIT STAFF ScreenShots.pdf
Form
2 MGA Feedback Survey SITE Staff screenshots
MGA Feedback Survey SITE STAFF ScreenShots.pdf
Form
MGA Fast Track (2).docx
MGA Fast Track
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CTSU Multi-Group Audit (MGA) Feedback Surveys
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
MGA Feedback Survey AUDIT Staff screenshots
MGA Feedback Survey AUDIT STAFF ScreenShots.pdf
Yes
Yes
Fillable Fileable
Form
2
MGA Feedback Survey SITE Staff screenshots
MGA Feedback Survey SITE STAFF ScreenShots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,500
0
2,500
0
0
0
Annual IC Time Burden (Hours)
417
0
417
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MGA Fast Track
MGA Fast Track (2).docx
02/12/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.