Information Collection

[NCEZID] DCIPHER External User Satisfaction Survey

IC 258886 under ICR 202402-0920-010 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1071 [NCEZID] DCIPHER External User Satisfaction Survey	Form and Instruction
0920-1071 DCIPHER External User Satisfaction Survey DCIPHER External User Satisfaction Survey.pdf	Form and Instruction
DCIPHER External User Satisfaction Survey Email.docx DCIPHER External User Satisfaction Survey Email	IC Document
Human Subjects Determination.pdf Human Subjects Determination	IC Document
Service Delivery Fast Track Template_DCIPHER External User Satisfaction Survey.docx Service Delivery Fast Track_DCIPHER External Use Satisfaction Survey	IC Document

IC Title:

[NCEZID] DCIPHER External User Satisfaction Survey

Agency IC Tracking Number:

0920-1071-23DE

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	0920-1071	DCIPHER External User Satisfaction Survey	DCIPHER External User Satisfaction 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: 400

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DCIPHER External User Satisfaction Survey Email	DCIPHER External User Satisfaction Survey Email.docx	03/03/2023
Human Subjects Determination	Human Subjects Determination.pdf	03/03/2023
Service Delivery Fast Track_DCIPHER External Use Satisfaction Survey	Service Delivery Fast Track Template_DCIPHER External User Satisfaction Survey.docx	03/03/2023

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