Information Collection

Feedback from GovDelivery Subscribers (NINR)

IC 237466 under ICR 202104-0925-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Feedback from GovDelivery Subscribers (NINR)	Form
1 Questions screenshot Questions_Screenshot.png	Form
1 Questions screenshot Questions_Screenshot.png	Form
FastTrack_NINR_GovDelivery_8_19_19.doc Fast track for GovDelivery Subscribers	IC Document
FastTrack_NINR_GovDelivery_8_19_19.doc Fast track for GovDelivery Subscribers	IC Document
Burden_Statement_Screenshot.png Burden Statement	IC Document
Burden_Statement_Screenshot.png Burden Statement	IC Document

IC Title:

Feedback from GovDelivery Subscribers (NINR)

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	Questions screenshot	Questions_Screenshot.png		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

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	20,000	20,000
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast track for GovDelivery Subscribers	FastTrack_NINR_GovDelivery_8_19_19.doc	08/19/2019
Burden Statement	Burden_Statement_Screenshot.png	08/19/2019

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