1 Screen Shots of Title V Information System Survey 2021

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Screen Shots of Title V Information System Survey 2021

OMB: 0915-0212

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0212 can be found here:

2024-01-10 - Revision of a currently approved collection
2024-01-04 - No material or nonsubstantive change to a currently approved collection

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Screen Shots of the previous Title V Information System (TVIS) User Satisfaction Survey created in SurveyMonkey. Once approved, the title will be updated with the new survey year, public burden statement, and expiration date.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Windows User
File Modified	0000-00-00
File Created	2023-12-24