Information Collection

Regulated Entity Technology Survey

IC 254431 under ICR 202204-0920-013 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.