Information Collection

DFWED Data System User Feedback Survey

IC 262153 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⚠️ Notice: This information collection may be referencing outdated material.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 DFWED Data System User Feedback Survey	Form
0920-1071 DFWED Data System User Feedback Survey DFWED System User Satisfaction_final.docx	Form
OMB DFWED system evaluation_Fast Track.docx Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number:) 0920-10	IC Document

IC Title:

DFWED Data System User Feedback Survey

Agency IC Tracking Number:

0920-1071-23IB

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	0920-1071	DFWED Data System User Feedback Survey	DFWED System User Satisfaction_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,100

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	1,100	1,100
Annual IC Time Burden (Hours)	275	275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval under the âGeneric Clearance for the Collection of Routine Customer Feedbackâ (OMB Control Number:) 0920-1071	OMB DFWED system evaluation_Fast Track.docx	09/13/2023

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