Information Collection

Editing Service Customer Feedback Survey (NIHL)

IC 233692 under ICR 202102-0925-005 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Editing Service Customer Feedback Survey (NIHL)	Form
1 Survey Survey.pdf	Form
1 Survey Survey.pdf	Form
Fast Track NIHL Editing Survey.docx Fast track NIHL Editing Survey	IC Document
Fast Track NIHL Editing Survey.docx Fast track NIHL Editing Survey	IC Document

IC Title:

Editing Service Customer Feedback Survey (NIHL)

Agency IC Tracking Number:

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
Form	1	Survey	Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track NIHL Editing Survey	Fast Track NIHL Editing Survey.docx	10/23/2018

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