Language Assistance Symbol

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

Documents and Forms

Document Name Document Type
LAS Survey 8-8-2024.docx Other-Survey
LAS Survey 8-8-2024.docx Other-Survey
MEMO_FastTrack Generic Clearance Submission LAS August 6 2024.docx memo IC Document
MEMO_FastTrack Generic Clearance Submission LAS August 6 2024.docx memo IC Document

Information Collection (IC) Details

IC Title:	Language Assistance Symbol	Agency IC Tracking Number:

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
Other-Survey			LAS Survey 8-8-2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
memo	MEMO_FastTrack Generic Clearance Submission LAS August 6 2024.docx	08/09/2024

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