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2020 Science Ambassador Application Survey
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0920-1050
IC ID: 240546
OMB.report
HHS/CDC
OMB 0920-1050
ICR 201902-0920-022
IC 240546
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:
2022-05-23 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-1050
2020 Science Ambassador Application Survey
Form and Instruction
Att_2_0920-1050_2020_Sci_Amb_Application_Survey_Screenshots_subm.docx
Other-WORD (Screenshots)
Att_3_0920-1050_2020_Sci_Amb_Application_Survey_Invitation_Email_subm.docx
Other-Email
Att_4_0920-1050_2020_Sci_Amb_Application_Survey_Reminder_Email_subm.docx
Other-Email
0920-1050 2020 Science Ambassador Application Survey
Att_1_0920-1050_2020_Sci_Amb_Application_Survey_subm.docx
Form and Instruction
GenIC Req_0920-1050_Sci_Amb_Application_Survey_subm_final.docx
Request for Approval
IC Document
SSA_New_Requirements_0920-1050_2020_Sci_Amb_Application_Survey_subm.docx
SSA_New Requirement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2020 Science Ambassador Application Survey
Agency IC Tracking Number:
0920-1050-20LF
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
0920-1050
2020 Science Ambassador Application Survey
Att_1_0920-1050_2020_Sci_Amb_Application_Survey_subm.docx
Yes
Yes
Fillable Printable
Other-WORD (Screenshots)
Att_2_0920-1050_2020_Sci_Amb_Application_Survey_Screenshots_subm.docx
No
Paper Only
Other-Email
Att_3_0920-1050_2020_Sci_Amb_Application_Survey_Invitation_Email_subm.docx
No
Printable Only
Other-Email
Att_4_0920-1050_2020_Sci_Amb_Application_Survey_Reminder_Email_subm.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
90
0
90
0
0
0
Annual IC Time Burden (Hours)
15
0
15
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Approval
GenIC Req_0920-1050_Sci_Amb_Application_Survey_subm_final.docx
03/06/2020
SSA_New Requirement
SSA_New_Requirements_0920-1050_2020_Sci_Amb_Application_Survey_subm.docx
03/06/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.