Benefits & Payroll Liaison Branch (BLPB) Customer Satisfaction Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Benefits & Payroll Liaison Branch (BLPB) Customer Satisfaction Survey Form and Instruction
1 Retiree Survey Retiree Survey.docx Form and Instruction
1 Retiree Survey Retiree Survey.docx Form and Instruction
Fast Track for BLPB retiree Survey.docx Fast Track for BLPB Retiree Survey IC Document
Fast Track for BLPB retiree Survey.docx Fast Track for BLPB Retiree Survey IC Document

Information Collection (IC) Details

IC Title:	Benefits & Payroll Liaison Branch (BLPB) Customer Satisfaction Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	1	Retiree Survey	Retiree Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track for BLPB Retiree Survey	Fast Track for BLPB retiree Survey.docx	02/16/2018

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