Information Collection

Feedback Survey for Community Counts Data Viz Tool

IC 261872 under ICR 202507-0920-010 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool Feedback Survey for Community Counts Data Viz Tool	Form and Instruction
0920-1154 Feedback Survey for Community Counts Data Viz Tool Att1_(genIC) Screenshots of CC Data Viz Feedback Survey_08102023.docx	Form and Instruction
(genIC) Community Counts Data Viz SSA_08102023__.docx 0920-1154 Supporting Statement A	IC Document
(genIC) Community Counts Data Viz SSB_08102023.docx 0920-1154 Supporting Statement B	IC Document
(genIC)_Request for Approval CC Data Viz_08102023_sc.docx GenIC Request Template	IC Document

IC Title:

Feedback Survey for Community Counts Data Viz Tool

Agency IC Tracking Number:

0920-1154-23HW

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	0920-1154			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: 100

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	100	100
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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