OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Strategic Plan Survey (ORA)

IC 239379 under ICR 201710-0910-006 · OMB 0910-0697.

Documents and Forms
Document Name
Document Type
Other-Survey Instrument
Other-Screenshot
Other-Screenshot
Other-Customer List
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Strategic Plan Survey (ORA) ORA
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Instrument Appendix I - Survey Tool.docx Yes Yes Fillable Fileable
Other-Screenshot Appendix II - Survey Tool Snapshot.docx Yes Yes Fillable Fileable
Other-Screenshot Appendix III - View After Submitting Survey.docx Yes No Printable Only
Other-Customer List Appendix IV - Customer List.docx Yes No Printable Only

Health Health Care Services

 

80 0
   
Private Sector Businesses or other for-profits
 
   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 80 0 80 0 0 0
Annual IC Time Burden (Hours) 80 0 80 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB approval memo 0697 OMB Approval Memo - Strategic Plan Development Survey 2020.docx 01/22/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.