NASA STI Impact Questionnaire

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2700-0153 can be found here:

Documents and Forms

Document Name Document Type
NASA STI Impact Questionnaire Form and Instruction
STI Impact Questionnaire.docx Form and Instruction
STI Impact - Request Form.docx Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	NASA STI Impact Questionnaire	Agency IC Tracking Number:

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	n/a	n/a	STI Impact Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Space Exploration and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	STI Impact - Request Form.docx	09/02/2011

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