HRSA HAB Recipeint Questionnaire-061 20316 A1

American Customer Satisfaction Index "Customer Satisfaction Surveys"

OMB: 1090-0007

IC ID: 237238

Information Collection (IC) Details

View Information Collection (IC)

HRSA HAB Recipeint Questionnaire-061 20316 A1 061-20316A1
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 061-20316 A1 HRSA HAB Recipient Questionnaire HRSA HAB Recipient Questionnaire -.docx Yes Yes Fillable Printable

General Government Central Records & Statistical Mgt

 

250 0
   
Individuals or Households
 
   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

Title Document Date Uploaded
Generic Clearance Request Form 1090-0007 Generic Clearance Request Form-signed.pdf 08/02/2019
OMB Mapping form HRSA HAB Recipient 2019 OMB Mapping Document.xlsx 08/02/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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