Information Collection

[OS NCCDPHP] Award Management Platform Customer Satisfaction Surveys-Division of Oral Health

IC 258442 under ICR 202505-0920-006 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 [OS NCCDPHP] Award Management Platform Customer Satisfaction Surveys-Division of Oral Health	Form and Instruction
Form 0920-1050 DOH TA Satisfaction Survey [OS NCCDPHP] Award Management Platform Customer Satisfaction Surveys-Division of Oral Health	Form and Instruction
0920-1050 DOH TA Satisfaction Survey Attachment 5- DOH AMP TA Satifaction Survey_Updated Flow_AMP revisions_10312020.docx	Form and Instruction
0920-1050 DOH TA Satisfaction Survey Attachment 5- DOH AMP TA Satifaction Survey_Updated Flow_AMP revisions_10312020.docx	Form and Instruction
Attachment 1- Customer Service GenIC Clearance Template (Final 5.3) AMP CSS.docx GenIC Request Template 0920-1050	IC Document
Attachment 1- Customer Service GenIC Clearance Template (Final 5.3) AMP CSS.docx GenIC Request Template 0920-1050	IC Document

IC Title:

[OS NCCDPHP] Award Management Platform Customer Satisfaction Surveys-Division of Oral Health

Agency IC Tracking Number:

0920-1050 -23CJ

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	0920-1050			NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 47

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
	Requested	Previously Approved
Annual Number of Responses for this IC	47	47
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request Template 0920-1050		02/09/2023

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

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