Information Collection

National Center on Law and Elder Rights-Resource Support Requests and User Satisfaction

IC 232653 under ICR 202111-0985-001 · OMB 0985-0060.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Center on Law and Elder Rights-Resource Support Requests and User Satisfaction	Form and Instruction
Uniform Resource Support Request Tool 0060 URSRT-Final.pdf	Form and Instruction
Uniform Resource Support Request Tool 0060 URSRT-Final.pdf	Form and Instruction
User Satisfaction Survey 0060 User Satisfaction Form.pdf	Form and Instruction
User Satisfaction Survey 0060 User Satisfaction Form.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	NA	Uniform Resource Support Request Tool	0060 URSRT-Final.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	NA	User Satisfaction Survey	0060 User Satisfaction Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,080

Number of Respondents for Small Entity: 175

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	14,080	14,080
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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