Beneficiaries

OMHA Annual Appellant Climate Survey

OMB: 0990-0330

IC ID: 184626

Information Collection (IC) Details

View Information Collection (IC)

Beneficiaries
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-letter Appendix C1. Introductory Letter-English.docx No   Paper Only
Other-letter Appendix C2. Introductory Letter-Spanish.docx No   Paper Only
Other-survey Appendix C3 Telephone Survey Introduction Script (English).docx No   Paper Only
Other-script Appendix C5 Reminder Voicemail Script (English).docx No   Paper Only
Other-script Appendix C6 Reminder Voicemail Script (Spanish).docx No   Paper Only
Other-script Appendix C4 Telephone Survey Introduction Script (Spanish).docx No   Paper Only
Other-survey Appendix C7. Reminder Letter with Mail Survey (English).docx No   Fillable Fileable
Other-survey Appendix C8. Reminder Letter with Mail Survey (Spanish).docx No   Paper Only

General Government Executive Functions

 

200 0
   
Individuals or Households
 
   0 %

  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 200 0 0 40 0 160
Annual IC Time Burden (Hours) 50 0 0 21 0 29
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
60-day 60-dayFederal Register, Volume 82 Issue 187 (Thursday, September 28, 2017).htm 01/26/2018
30day 30-day Federal Register, Volume 82 Issue 247 (Wednesday, December 27, 2017).htm 01/26/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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