2018 016 CMS - InsureKidsNow_20180810

E-Government Website Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 016 2018 016 CMS - InsureKidsNow_20180810 Form and Instruction
016 2018 016 CMS - InsureKidsNow_20180810 2018 016 CMS - InsureKidsNow_20180810.xlsx Form and Instruction
1090-0008 Survey Mapping Document CMS.docx 1090-0008 Survey Mapping Document CMS IC Document
1090-0008 Generic Clearance Request Form_USDHHS CMS_InsureKidsNow.gov Informational Survey.pdf 1090-0008 Generic Clearance Request Form_USDHHS CMS_InsureKidsNow.gov Informational Survey IC Document

Information Collection (IC) Details

IC Title:	2018 016 CMS - InsureKidsNow_20180810	Agency IC Tracking Number:	016

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	016	2018 016 CMS - InsureKidsNow_20180810	2018 016 CMS - InsureKidsNow_20180810.xlsx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	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	3,600	3,600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1090-0008 Survey Mapping Document CMS	1090-0008 Survey Mapping Document CMS.docx	09/25/2018
1090-0008 Generic Clearance Request Form_USDHHS CMS_InsureKidsNow.gov Informational Survey	1090-0008 Generic Clearance Request Form_USDHHS CMS_InsureKidsNow.gov Informational Survey.pdf	09/25/2018

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