Information Collection

MHS Facilities Design Survey

IC 266851 under ICR 202505-0704-008 · OMB 0704-0553.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2024 Facilities Survey Spouse_5.10.2024.docx	Other-Telephone Survey
2024 Facilities Survey Spouse_5.10.2024.docx	Other-Telephone Survey
0704-0553_One Pager_Facilities Design Survey_05.10.2024.docx One Page Justification	IC Document
0704-0553_One Pager_Facilities Design Survey_05.10.2024.docx One Page Justification	IC Document

IC Title:

Agency IC Tracking Number:

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
Other-Telephone Survey					Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	176	176

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
One Page Justification		05/10/2024

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

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