Information Collection

Communication Within DCRI Survey (CC)

IC 257056 under ICR 202103-0925-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 DCRO Communication survey Communication Within DCRI Survey (CC)	Form
1 DCRO Communication survey DCRI Comm Survey.docx	Form
Request for approval - Comm Survey rev2.docx fast track for DCRI Communication survey	IC Document
Comm Survey Email for 2022.docx email invite	IC Document

IC Title:

Communication Within DCRI Survey (CC)

Agency IC Tracking Number:

IC Status: New

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				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track for DCRI Communication survey		11/22/2022
email invite		11/22/2022

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

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