Information Collection

OLAW Conversations Session 3, February 24, 2022 Topic-specific Customer Feedback Poll (OD)

IC 251639 under ICR 202307-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 OLAW Conversations Session 3, February 24, 2022 Topic-specific Customer Feedback Poll (OD)	Form
1 Poll questions Poll questions (2).docx	Form
Fast track template OLAW Conversations Session 3 Feb 24 2022 Customer Feedback Poll (1).docx fast track template for OLAW Conversation Session 3: February 24	IC Document

IC Title:

OLAW Conversations Session 3, February 24, 2022 Topic-specific Customer Feedback Poll (OD)

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	1	Poll questions	Poll questions (2).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
fast track template for OLAW Conversation Session 3: February 24	Fast track template OLAW Conversations Session 3 Feb 24 2022 Customer Feedback Poll (1).docx	02/16/2022

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