Information Collection

HRSA OPAE Grantee Satisfaction Survey-20914A0

IC 237374 under ICR 201805-1090-002 · OMB 1090-0007.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.