Rockledge 1 and 2 Furniture Mockup Feedback

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

OMB: 0925-0642

IC ID: 230939

Information Collection (IC) Details

View Information Collection (IC)

Rockledge 1 and 2 Furniture Mockup Feedback
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Mockup Furniture Survey Card 040418-PRA-RKL 1-2 Mockup Furniture Survey Card-updated.pptx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,000 0
   
Individuals or Households
 
   100 %

  Requested 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 3,000 0 0 0 0 3,000
Annual IC Time Burden (Hours) 250 0 0 0 0 250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RKL 1-2 Mockup Survey OMB Form 032918-PRA-Request-RKL 1-2 Mockup Survey-OMB Form_RockI-II.docx 04/04/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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