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511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx
American Customer Satisfaction Index "Customer Satisfaction Surveys"
OMB: 1090-0007
IC ID: 203404
OMB.report
DOI/ASPMB
OMB 1090-0007
ICR 200908-1090-001
IC 203404
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:
2021-09-21 - Extension without change of a currently approved collection
2018-07-27 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 511
511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx
Form and Instruction
511 2012 511 LBI ACSI Questionnaire FINAL.docx
2012 511 LBI ACSI Questionnaire FINAL.docx
Form and Instruction
512 2012 512 SCSE ACSI Questionnaire FINAL.docx
2012 512 SBSE ACSI Questionnaire FINAL.docx
Form and Instruction
513 2012 513 WI ASCI Questionnaire FINAL.doc
2012 513 WI ACSI Questionnaire FINAL.doc
Form and Instruction
514 2012 514 Customer Contact Center Survey E-Verify.docx
2012 514 Customer Contact Center Survey E-Verify.docx
Form and Instruction
515 2012 515 HRSA BPHC Grantee Survey 7-16-12.docx
2012 515 HRSA BPHC Grantee Survey 7-16-12.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx
Agency IC Tracking Number:
511 - 515
IC Status:
New
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
Form and Instruction
511
2012 511 LBI ACSI Questionnaire FINAL.docx
2012 511 LBI ACSI Questionnaire FINAL.docx
No
Printable Only
Form and Instruction
512
2012 512 SCSE ACSI Questionnaire FINAL.docx
2012 512 SBSE ACSI Questionnaire FINAL.docx
No
Printable Only
Form and Instruction
513
2012 513 WI ASCI Questionnaire FINAL.doc
2012 513 WI ACSI Questionnaire FINAL.doc
No
Printable Only
Form and Instruction
514
2012 514 Customer Contact Center Survey E-Verify.docx
2012 514 Customer Contact Center Survey E-Verify.docx
Yes
Yes
Fillable Fileable
Form and Instruction
515
2012 515 HRSA BPHC Grantee Survey 7-16-12.docx
2012 515 HRSA BPHC Grantee Survey 7-16-12.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
40 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,250
0
1,250
0
0
0
Annual IC Time Burden (Hours)
208
0
208
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.