Intranet Customers Feedback

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Document Name Document Type
0990-0379 -FT Generic IntranetHHS.gov Surveys.pdf Other-FT Generic Survey
0990-0379 -FT Generic IntranetHHS.gov Surveys.pdf Other-FT Generic Survey
Updated Intranet Qualtrics Survey_.pdf Other-Survey change
Updated Intranet Qualtrics Survey_.pdf Other-Survey change
0990-0379 memo -IntranetHHS.gov.docx memo IC Document
0990-0379 memo -IntranetHHS.gov.docx memo IC Document

Information Collection (IC) Details

IC Title:	Intranet Customers Feedback	Agency IC Tracking Number:

IC Status: Modified

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
Other-FT Generic Survey			0990-0379 -FT Generic IntranetHHS.gov Surveys.pdf		Yes	Yes	Fillable Fileable
Other-Survey change			Updated Intranet Qualtrics Survey_.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
memo	0990-0379 memo -IntranetHHS.gov.docx	08/17/2021

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