Information Collection

Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division

IC 235082 under ICR 202310-0935-001 · OMB 0935-0179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division	Form and Instruction
Form 1 Nominator/Partner Survey Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division	Form and Instruction
1 Nominator/Partner Survey Customer Satisfaction Survey_Partner_Nominator_DRAFT REVISED _02222019.docx	Form and Instruction
1 Nominator/Partner Survey Customer Satisfaction Survey_Partner_Nominator_DRAFT REVISED _02222019.docx	Form and Instruction
Generic Clearance Submission Partner Interview_10292018 (1).doc Supporting Statement	IC Document
Generic Clearance Submission Partner Interview_10292018 (1).doc Supporting Statement	IC Document
OMB Cover Letter.doc Cover Letter	IC Document
OMB Cover Letter.doc Cover Letter	IC Document
NewParnterEmailInvitation_rev.docx Invitation	IC Document
NewParnterEmailInvitation_rev.docx Invitation	IC Document

IC Title:

Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division

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 and Instruction	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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: 50 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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