Fatigue Prevention Training Module Customer Satisfaction and Feedback Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH 2)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0953 can be found here:

Documents and Forms

Document Name Document Type
Fatigue Prevention Training Module Customer Satisfaction and Feedback Survey Form and Instruction
NIOSH Fatigue Prevention Training Module Survey Fatigue prev training survey 30NOV2014.pdf Form and Instruction
Request for Approval 1DEC2014.docx GenIC Request for Approval 0920-0953 IC Document

Information Collection (IC) Details

IC Title:	Fatigue Prevention Training Module Customer Satisfaction and Feedback Survey	Agency IC Tracking Number:	15FP

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	None	NIOSH Fatigue Prevention Training Module Survey	Fatigue prev training survey 30NOV2014.pdf	None	No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request for Approval 0920-0953	Request for Approval 1DEC2014.docx	12/01/2014

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