Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Documents and Forms

Document Name Document Type
Form 5800-041 Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process Form
5800-041 ORD State Engagement Feedback Survey Survey Questions - ORD Survey on RACT Process.docx Form
Justification Form - ORD Survey on RACT Process.docx Justification IC Document

Information Collection (IC) Details

IC Title:	Customer Satisfaction Survey for State Government Officials that Participated in the Office of Research and Development's FY2019-2022 Strategic Research Planning and Implementation Process	Agency IC Tracking Number:	1234.135

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5800-041	ORD State Engagement Feedback Survey	Survey Questions - ORD Survey on RACT Process.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	Justification Form - ORD Survey on RACT Process.docx	03/11/2021

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