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ACSI Survey HRSA BHW NURSE Corps
American Customer Satisfaction Index "Customer Satisfaction Surveys"
OMB: 1090-0007
IC ID: 233382
OMB.report
DOI/ASPMB
OMB 1090-0007
ICR 201805-1090-002
IC 233382
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:
2021-09-21 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 023-20317 A1 (2)
ACSI Survey HRSA BHW NURSE Corps
Form and Instruction
023-20317 A1 (2) HRSA BHW Nurse Corps Participant Survey
NURSE Corps 2018 Participant Survey_IA 20317.xlsx
Form and Instruction
1090-0007 Generic Clearance Request Form HRSA NURSE Corp_IA 20317 A1-.pdf
ACSI Survey HRSA BHW NURSE Corps
IC Document
OMB Mapping HRSA NURSE Corp IA 20317 A1.xlsx
ACSI Survey HRSA BHW NURSE Corps
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ACSI Survey HRSA BHW NURSE Corps
Agency IC Tracking Number:
023-20317 A1 (2)
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
023-20317 A1 (2)
HRSA BHW Nurse Corps Participant Survey
NURSE Corps 2018 Participant Survey_IA 20317.xlsx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
250
0
250
0
0
0
Annual IC Time Burden (Hours)
50
0
50
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
ACSI Survey HRSA BHW NURSE Corps
1090-0007 Generic Clearance Request Form HRSA NURSE Corp_IA 20317 A1-.pdf
10/03/2018
ACSI Survey HRSA BHW NURSE Corps
OMB Mapping HRSA NURSE Corp IA 20317 A1.xlsx
10/03/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.