Information Collection

Federal State Audit Branch Feedback Form

IC 225180 under ICR 201803-0583-003 · OMB 0583-0151.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0151 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5720-3a Federal State Audit Branch Feedback Form	Form and Instruction
5720-3a Federal State Audit Branch (FSAB) Voluntary Feedback For 5720-3a FSAB Voluntary Feedback Form.pdf	Form and Instruction
request for approval FSAB Feedback Form.pdf Request for Approval: Federal State Audit Branch Feedback Form	IC Document

IC Title:

Federal State Audit Branch Feedback Form

Agency IC Tracking Number:

IC Status: Unchanged

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 and Instruction	5720-3a	Federal State Audit Branch (FSAB) Voluntary Feedback Form	5720-3a FSAB Voluntary Feedback Form.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	27	27
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval: Federal State Audit Branch Feedback Form	request for approval FSAB Feedback Form.pdf	01/17/2017

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