Information Collection

HRSA Grantee Satisfaction

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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 HRSA Grantee Satisfaction Survey 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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	1				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 %

table that charts list of burden
	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

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.

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