2019 233 MHS Genesis Beneficiaries Feedback Survey

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⚠️ Notice: This information collection may be referencing outdated material.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 233 2019 233 MHS Genesis Beneficiaries Feedback Survey Form and Instruction
233 2019 233 MHS Genesis Beneficiaries Feedback Survey 2019 233 MHS Genesis Beneficiaries Feedback Survey.docx Form and Instruction
1090-0008 Generic Clearance Request Form 09132018 July 8 2019 TRICARE MH.pdf 1090-0008 Generic Clearance Request Form 09132018 July 8 2019 TRICARE MH IC Document

Information Collection (IC) Details

IC Title:	2019 233 MHS Genesis Beneficiaries Feedback Survey	Agency IC Tracking Number:	233

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	233	2019 233 MHS Genesis Beneficiaries Feedback Survey	2019 233 MHS Genesis Beneficiaries Feedback Survey.docx		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 Generic Clearance Request Form 09132018 July 8 2019 TRICARE MH	1090-0008 Generic Clearance Request Form 09132018 July 8 2019 TRICARE MH.pdf	07/23/2019

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