Information Collection

Earthrise Feedback Questionnaire

IC 267347 under ICR 202407-2700-003 · OMB 2700-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2700-0153 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Earthrise Feedback Questionnaire (4-30-24).docx www.surveymonkey.com/r/SYCZTZJ	Other-Text
Earthrise Feedback Questionnaire (4-30-24).docx www.surveymonkey.com/r/SYCZTZJ	Other-Text
Earthrise Feedback Questionnaire SCREEN SHOTS (4-30-24).docx	Other-Screen shots
Earthrise Feedback Questionnaire SCREEN SHOTS (4-30-24).docx	Other-Screen shots
Earthrise Newsletter Screen Shot with Survey Language (4-24-24).docx	Other-Newsletter sample
Earthrise Newsletter Screen Shot with Survey Language (4-24-24).docx	Other-Newsletter sample
Earthrise Feedback Questionnaire - Fast Track Short Form (4-23-24).docx Earthrise fast track form	IC Document
Earthrise Feedback Questionnaire - Fast Track Short Form (4-23-24).docx Earthrise fast track form	IC Document

IC Title:

Earthrise Feedback Questionnaire

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Text	Earthrise Feedback Questionnaire (4-30-24).docx	https://www.surveymonkey.com/r/SYCZTZJ	Yes	Yes	Fillable Fileable
Other-Screen shots	Earthrise Feedback Questionnaire SCREEN SHOTS (4-30-24).docx		Yes	Yes	Fillable Fileable
Other-Newsletter sample	Earthrise Newsletter Screen Shot with Survey Language (4-24-24).docx		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,700

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,700	1,700
Annual IC Time Burden (Hours)	142	142
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Earthrise fast track form	Earthrise Feedback Questionnaire - Fast Track Short Form (4-23-24).docx	04/30/2024

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