Information Collection

HRSA Grantee Satisfaction

IC 265088 under ICR 202405-0906-002 · OMB 0906-0006.

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HRSA Grantee Satisfaction	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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	01302024 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: 1,171	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	375	375
Annual IC Time Burden (Hours)	127	127
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.