Information Collection Request

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

ICR 202406-0990-001 · OMB 0990-0379 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0990-0379 OIG HHS Website feedback Form and Instruction Unchanged Repair queued
Form 1 National Hypertension Control Initiative (NHCI) Community Health Center Assessment Form and Instruction Unchanged Repair queued
HHS Survery Change_Memo_Feb 2024.pdf Justification for No Material/Nonsubstantive Change Uploaded 2024-02-21 Repair queued
HHS.gov Slider Survey UPDATES_2.1.2024.pdf Supplementary Document Uploaded 2024-02-21 Repair queued
HHS.gov Slider Survey CURRENT Version_1.2.24.pdf Supplementary Document Uploaded 2024-02-21 Repair queued
Intranet Survey.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-06-17 Repair queued
0990-0379 Change Request_DKC.doc Justification for No Material/Nonsubstantive Change Uploaded 2015-03-03 Repair queued
0990-0379_B.docx Supporting Statement B Uploaded 2014-07-02 Repair queued
0990-0379_Father Generic 10_5_23 (3).docx Supporting Statement A Uploaded 2023-10-11 Repair queued
Generic Clearance Submission Template.docx Supplementary Document Uploaded 2011-06-14 Repair queued

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
10/31/2026 10/31/2026
300,000 300,000
50,000 50,000
0 0





table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 300,000 300,000 0 0 0 0
Annual Time Burden (Hours) 50,000 50,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No