IHS OEHE Customer Satisfaction Forms

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: IHS Customer Service Satisfaction and Similar Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Document Name Document Type
Form 0917-0036 IHS OEHE Customer Satisfaction Forms Form and Instruction
0917-0036 Annual Operator O & M Survey 0917-0036, Annual Operator O & M Survey.doc Form and Instruction
0917-0036 Post-Construction O & M Survey 0917-0036, Post Construction O & M Survey.doc Form and Instruction
0917-0036 Tribal Homeowner Survey 0917-0036, Tribal Homeowner Survey.doc Form and Instruction
0917-0036 Tribal Partner Survey 0917-0036, Tribal Partner Survey.doc Form and Instruction
OMB No. 0917-0036, Mini-Supporting Statement for IHS OEHE customer awareness.doc OMB No. 0917-0036, Mini-Supporting Statement for IHS OEHE Customer Satisfaction Forms IC Document

Information Collection (IC) Details

IC Title:	IHS OEHE Customer Satisfaction Forms	Agency IC Tracking Number:	20

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0917-0036	Annual Operator O & M Survey	0917-0036, Annual Operator O & M Survey.doc	Yes	Yes	Fillable Fileable
Form and Instruction	0917-0036	Post-Construction O & M Survey	0917-0036, Post Construction O & M Survey.doc	Yes	Yes	Fillable Fileable
Form and Instruction	0917-0036	Tribal Homeowner Survey	0917-0036, Tribal Homeowner Survey.doc	Yes	Yes	Fillable Fileable
Form and Instruction	0917-0036	Tribal Partner Survey	0917-0036, Tribal Partner Survey.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-1,800	1,800
Annual IC Time Burden (Hours)	-90	90
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB No. 0917-0036, Mini-Supporting Statement for IHS OEHE Customer Satisfaction Forms	OMB No. 0917-0036, Mini-Supporting Statement for IHS OEHE customer awareness.doc	05/07/2015

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