Information Collection

2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20

IC 244676 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⚠️ Notice: This information collection may be referencing outdated material.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 100 2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20	Form and Instruction
100 2020 100 HRSA HAB CAREWare Customer Satisfaction and Use 2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20.docx	Form and Instruction
OMB Mapping Cover Template_HRSA-CAREWare_2020.xlsx OMB Mapping Cover Template_HRSA-CAREWare_2020	IC Document
1090-0007 Generic Clearance Request Form_HRSA CAREWare_2020.pdf 1090-0007 Generic Clearance Request Form_HRSA CAREWare_2020	IC Document

IC Title:

2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20

Agency IC Tracking Number:

100

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	100	2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20	2020 100 HRSA HAB CAREWare Customer Satisfaction and User Questionnaire - 10.13.20.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: 300

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	300	300
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Mapping Cover Template_HRSA-CAREWare_2020	OMB Mapping Cover Template_HRSA-CAREWare_2020.xlsx	11/30/2020
1090-0007 Generic Clearance Request Form_HRSA CAREWare_2020	1090-0007 Generic Clearance Request Form_HRSA CAREWare_2020.pdf	11/30/2020

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