HRSA OPAE Grantee Satisfaction Survey-20914A0

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 063-20914 A0 HRSA OPAE Grantee Satisfaction Survey-20914A0 Form and Instruction
063-20914 A0 2019 HRSA OPAE Grantee Satisfaction Survey 2019 HRSA GRANTEE SATISFACTION SURVEY - 20914A0.docx Form and Instruction
Generic Clearance Request Form_HRSA 063-209014-signed.pdf Generic Clearance Form Request-HRSA OPAE IC Document
OMB Mapping Cover_HRSA OPAE 2019 (1).xlsx OMB Mapping Cover for HRSA OPAE 20914A0 IC Document

Information Collection (IC) Details

IC Title:	HRSA OPAE Grantee Satisfaction Survey-20914A0	Agency IC Tracking Number:	063-20914A0

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	063-20914 A0	2019 HRSA OPAE Grantee Satisfaction Survey	2019 HRSA GRANTEE SATISFACTION SURVEY - 20914A0.docx		Yes	Yes	Fillable Printable

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 Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Form Request-HRSA OPAE	Generic Clearance Request Form_HRSA 063-209014-signed.pdf	08/15/2019
OMB Mapping Cover for HRSA OPAE 20914A0	OMB Mapping Cover_HRSA OPAE 2019 (1).xlsx	08/15/2019

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