Regulated Entity Technology Survey

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

Documents and Forms

Document Name Document Type
Form 0920-1050 Regulated Entity Technology Survey Form and Instruction
0920-1050 User Experience Survey Att1 - eFSAP IPP User Experience Survey_final.docx Form and Instruction
0920-1050 Request Template -CPR -Regulated Entity Technology Survey_final.docx GenIC Request Template IC Document

Information Collection (IC) Details

IC Title:	Regulated Entity Technology Survey	Agency IC Tracking Number:	0920-1050-22GE

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 and Instruction	0920-1050	User Experience Survey	Att1 - eFSAP IPP User Experience Survey_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,264	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,264	2,264
Annual IC Time Burden (Hours)	377	377
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Template	0920-1050 Request Template -CPR -Regulated Entity Technology Survey_final.docx	06/29/2022

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