HSICC Post Phone Call Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 HSICC Post Phone Call Survey Form and Instruction
1 Post Phone Calll Survey Post Phone Call Survey.docx Form and Instruction
fast-track-PRA-submission-short-form-hsicc (1).doc Justification IC Document

Information Collection (IC) Details

IC Title:	HSICC Post Phone Call Survey	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 and Instruction	1	Post Phone Calll Survey	Post Phone Call Survey.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	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	300	300
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	fast-track-PRA-submission-short-form-hsicc (1).doc	08/20/2018

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