Information Collection

2024 Butler-Williams Scholars Program Feedback Survey (NIA)

IC 266218 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⚠️ Notice: This information collection may be referencing outdated material.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 Survey 2024 Butler-Williams Scholars Program Feedback Survey (NIA)	Form
1 Survey BW_Survey Questions _SurveyMonkey.docx	Form
NIA OMB Clearance Form_2024 BWSP Feedback Survey V2.docx Template	IC Document
Email Correspondence.docx Email Correspondence	IC Document

IC Title:

2024 Butler-Williams Scholars Program Feedback Survey (NIA)

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: 275

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	275	275
Annual IC Time Burden (Hours)	46	46
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		03/27/2024
Email Correspondence		03/22/2024

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

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