OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

DELTA Reverse Site Visit Feedback

IC 243166 under ICR 201902-0920-022 · OMB 0920-1050.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Email
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

DELTA Reverse Site Visit Feedback 0920-1050-20RJ
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1050 2020 Reverse Site Visit Feedback Form Att. 1_- 2020 Reverse Site Visit Feedback Form.docx Yes Yes Fillable Fileable
Other-Email Att. 2 - Invitation emil.docx No   Printable Only

Health Consumer Health and Safety

 

120 0
   
Individuals or Households
 
   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 120 0 120 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

Title Document Date Uploaded
Request for Approval 1050 Generic Request - DELTA Reverse Site Visit Feedback8.6.20.docx 08/13/2020
Att 3_Privacy At. 3 - Privacy.pdf 08/13/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.