CDC INFO Email Survey [ALT title: CDC-INFO Web-based Satisfaction Survey (for Individual Respondents Who Send Email Inquiries)]

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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
CDC INFO Email Survey [ALT title: CDC-INFO Web-based Satisfaction Survey (for Individual Respondents Who Send Email Inquiries)] Form and Instruction
Survey (English language) Survey_English.pdf Form and Instruction
Survey (Spanish) Survey_Spanish.pdf Form and Instruction
Generic Clearance Submission Template_2019_Email Survey_Individual Respondents_2019705.docx Template with Project Description IC Document

Information Collection (IC) Details

IC Title:	CDC INFO Email Survey [ALT title: CDC-INFO Web-based Satisfaction Survey (for Individual Respondents Who Send Email Inquiries)]	Agency IC Tracking Number:	0920-19BKO

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	n/a	Survey (Spanish)	Survey_Spanish.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Survey (English language)	Survey_English.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 288	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	288	288
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Template with Project Description	Generic Clearance Submission Template_2019_Email Survey_Individual Respondents_2019705.docx	07/08/2019

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