Information Collection

HRSA Grantee Satisfaction

IC 214691 under ICR 202402-0906-001 · OMB 0906-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 HRSA Grantee Satisfaction	Form and Instruction
1 HRSA Grantee Satisfaction Survey 01302024 Revised HRSA Grantee Satisfaction Survey - Final Instrument 0906-0006.docx	Form and Instruction
1 HRSA Grantee Satisfaction Survey 03042024 Revised HRSA Grantee Satisfaction Survey - Final Instrument 0906-0006.docx	Form and Instruction

IC Title:

HRSA Grantee Satisfaction

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	HRSA Grantee Satisfaction Survey	03042024 Revised HRSA Grantee Satisfaction Survey - Final Instrument 0906-0006.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,641

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	2,125	2,125
Annual IC Time Burden (Hours)	723	723
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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