CSPECE Resources Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
CSPECE Resources Survey Form
CSPECE Resources Survey AttB CSPECE Resources Survey (screenshots) 20200218.docx Form
CSPECE Resources Survey - text AttC CSPECE Resources Survey (text) 20200218.docx Form
AttA Email Invitation for Survey 20200218.docx Survey invitation IC Document
AttD Email Reminder 20200218.docx Email reminder IC Document
AttE Final Email Reminder 20200218.docx Final reminder IC Document
AttF Research and PRA Determination.pdf Determination IC Document
0923-0047 SrvcDelvry_GenIC_CSPECE Rssrces Survey 20200218.docx genIC Request for Approval IC Document

Information Collection (IC) Details

IC Title:	CSPECE Resources Survey	Agency IC Tracking Number:	0923-0047-20JF

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	none	CSPECE Resources Survey	AttB CSPECE Resources Survey (screenshots) 20200218.docx		Yes	Yes	Fillable Fileable
Form	none	CSPECE Resources Survey - text	AttC CSPECE Resources Survey (text) 20200218.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey invitation	AttA Email Invitation for Survey 20200218.docx	02/24/2020
Email reminder	AttD Email Reminder 20200218.docx	02/24/2020
Final reminder	AttE Final Email Reminder 20200218.docx	02/24/2020
Determination	AttF Research and PRA Determination.pdf	02/24/2020
genIC Request for Approval	0923-0047 SrvcDelvry_GenIC_CSPECE Rssrces Survey 20200218.docx	02/24/2020

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