Assessment of 2018 HINTS Data Users Conference (NCI)

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⚠️ Notice: This information collection may be referencing outdated material.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 Assessment of 2018 HINTS Data Users Conference (NCI) Form
1 HINTS survey Screen shots HINTS survey[1].pdf Form
Fast Track Request HINTS Data Users_Rev.docx Fast Track Assessment of 2018 HINTS Data IC Document
Invitation email for HINTS survey FINAL.DOCX Invitation email for HINTS IC Document

Information Collection (IC) Details

IC Title:	Assessment of 2018 HINTS Data Users Conference (NCI)	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	HINTS survey	Screen shots HINTS survey[1].pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	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	150	150
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Assessment of 2018 HINTS Data	Fast Track Request HINTS Data Users_Rev.docx	08/23/2018
Invitation email for HINTS	Invitation email for HINTS survey FINAL.DOCX	08/23/2018

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