Information Collection

Information Technology (IT) Service Management - Service Now Customer Satisfaction Survey

IC 253264 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⚠️ Notice: This information collection may be referencing outdated material.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 0917-0036-104 Service Now Surveys Information Technology (IT) Service Management - Service Now Customer Satisfaction Survey	Form and Instruction
0917-0036-104 Service Now Surveys IHS ServiceNow Surveys.pdf	Form and Instruction
ServiceNow Clearance Submission Template - IHS.docx Supportive Template	IC Document

IC Title:

Information Technology (IT) Service Management - Service Now Customer Satisfaction Survey

Agency IC Tracking Number:

104

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 and Instruction	0917-0036-104				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	3,000	3,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supportive Template		05/05/2022

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

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