Information Collection

Chinle Service Unit (CSU) Employee Satisfaction Survey.

IC 217690 under ICR 202201-0917-001 · OMB 0917-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0917-0036 Chinle Service Unit (CSU) Employee Satisfaction Survey.	Form and Instruction
0917-0036 CSU Employee Survey 2015 CSU Employee Survey 2015, with TClay edits, 6-25-2015.pdf	Form and Instruction
0917-0036 CSU Employee Survey 2015 CSU Employee Survey 2015, with TClay edits, 6-25-2015.pdf	Form and Instruction
0917-0036, Mini-Supporting Statment for Chinle Service Unit Employee Survey.doc 0917-0036, Mini-supporting Statment for CSU Employee Survey	IC Document
0917-0036, Mini-Supporting Statment for Chinle Service Unit Employee Survey.doc 0917-0036, Mini-supporting Statment for CSU Employee Survey	IC Document

IC Title:

Chinle Service Unit (CSU) Employee Satisfaction Survey.

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 and Instruction	0917-0036	CSU Employee Survey 2015	CSU Employee Survey 2015, with TClay edits, 6-25-2015.pdf		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

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	2,400	2,400
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0917-0036, Mini-supporting Statment for CSU Employee Survey	0917-0036, Mini-Supporting Statment for Chinle Service Unit Employee Survey.doc	07/29/2015

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