Information Collection

[NCIRD] IP25-0007 CoAg S3.4 Customer Satisfaction Evaluation

IC 279045 under ICR 202506-0920-002 · OMB 0920-1050.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Customer Satisfaction Surveys to Assess the Quality of S3.4 Technical Assistance [NCIRD] IP25-0007 CoAg S3.4 Customer Satisfaction Evaluation	Form and Instruction
Customer Satisfaction Surveys to Assess the Quality of S Customer Satisfaction Surveys to Assess the Quality of S3.4_final.docx	Form and Instruction
Customer Service GenIC Clearance Template_final_S3.4TA_final.docx Customer Service GenIC Clearance Template	IC Document

IC Title:

Agency IC Tracking Number:

0920-26-0027

IC Status: New

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	n/a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 33

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Customer Service GenIC Clearance Template		02/10/2026

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

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