Information Collection

Community Pulse Check (CPC) Digital Comment Card

IC 236636 under ICR 201710-2900-001 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 001 CPC_SurveyWireframe2_v2_withNewQuestion_061719 Community Pulse Check (CPC) Digital Comment Card	Form
Form 001 CPC_SurveyWireframe2_v2_07162019.pdf Community Pulse Check (CPC) Digital Comment Card	Form
001 CPC_SurveyWireframe2_v2_withNewQuestion_061719 CPC_SurveyWireframe2_v2_withNewQuestion_061719.pdf	Form
001 CPC_SurveyWireframe2_v2_07162019.pdf CPC_SurveyWireframe2_v2_07162019.pdf	Form
CPC_FastTrackClearance_06.24.19.docx Community Pulse Check (CPC) Digital Comment Card Request for Approval	IC Document

IC Title:

Community Pulse Check (CPC) Digital Comment Card

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	001	CPC_SurveyWireframe2_v2_07162019.pdf	CPC_SurveyWireframe2_v2_07162019.pdf		Yes	Yes	Fillable Fileable
Form	001	CPC_SurveyWireframe2_v2_withNewQuestion_061719	CPC_SurveyWireframe2_v2_withNewQuestion_061719.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,000	9,000
Annual IC Time Burden (Hours)	750	750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Community Pulse Check (CPC) Digital Comment Card Request for Approval	CPC_FastTrackClearance_06.24.19.docx	06/24/2019

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