Feedback web-survey on forensic toxicology testing

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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-1050 Feedback web-survey on forensic toxicology testing Form and Instruction
Att_1a_Screenshot Customer Feedback_cl.docx Other-Screenshot
0920-1050 Customer Feedback Forensic Toxicology Att_1_ Customer Feedback_cl.docx Form and Instruction
1050_Request_Forenscis_Tox_Service.docx Request for Approval IC Document
Att_2_Invitation_email_cl.docx Att 2_Invitational E-mail IC Document
Att_3_Privacy Applicability.pdf Att 3_Privacy Applicability IC Document

Information Collection (IC) Details

IC Title:	Feedback web-survey on forensic toxicology testing	Agency IC Tracking Number:	0920-1050-20RA

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	Customer Feedback Forensic Toxicology	Att_1_ Customer Feedback_cl.docx		Yes	Yes	Fillable Fileable
Other-Screenshot			Att_1a_Screenshot Customer Feedback_cl.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,618	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	3,618	3,618
Annual IC Time Burden (Hours)	922	922
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	1050_Request_Forenscis_Tox_Service.docx	08/05/2020
Att 2_Invitational E-mail	Att_2_Invitation_email_cl.docx	08/05/2020
Att 3_Privacy Applicability	Att_3_Privacy Applicability.pdf	08/05/2020

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