Information Collection

Staff survey

IC 227919 under ICR 202003-0970-002 · OMB 0970-0506.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0506 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment E Staff Survey.docx	Other-Survey
Attachment L Staff Survey QxQ.DOCX Attachment L - Question by Question Justification - Staff Survey	IC Document

IC Title:

Staff survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Attachment E Staff Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment L - Question by Question Justification - Staff Survey	Attachment L Staff Survey QxQ.DOCX	08/15/2017

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