494 HRSA NELRP and NSP 2012 Participant Questionnaire

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 494 494 HRSA NELRP and NSP 2012 Participant Questionnaire Form and Instruction
494 494 HRSA NELRP and NSP Participant Questionnaire 2012 494 HRSA NELRP and NSP 2012 Participant Questionnaire 3-13-12.docx Form and Instruction

Information Collection (IC) Details

IC Title:	494 HRSA NELRP and NSP 2012 Participant Questionnaire	Agency IC Tracking Number:	494

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	494	494 HRSA NELRP and NSP Participant Questionnaire	2012 494 HRSA NELRP and NSP 2012 Participant Questionnaire 3-13-12.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	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.