Information Collection

2022 NIEHS CFC Survey

IC 258477 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⚠️ Notice: This information collection may be referencing outdated material.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 CFC survey 2022 NIEHS CFC Survey	Form
1 CFC survey 2022 Combined Federal Campaign Survey.docx	Form
0925-0648 CFC Survey 09FEB2023 (1).docx fast track for CFC 2022 Survey	IC Document
CFC All Hands Message Jan 25 2023 (1).docx email invitation	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

2022 NIEHS CFC Survey

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

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0156 Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD

FR Citation: 67 FR 67042

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	100	100
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track for CFC 2022 Survey		02/10/2023
email invitation		02/10/2023

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

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