User Fee Website Survey

Customer/Partner Service Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0360 can be found here:

Documents and Forms

Document Name Document Type
User_Fee_Survey.doc Other-Screen shot of webste based su
User_Fee_Website_Survey.doc User Fee Website Survey Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	User Fee Website Survey	Agency IC Tracking Number:	Generic

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
Other-Screen shot of webste based survey			User_Fee_Survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,400	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	1,400	1,400
Annual IC Time Burden (Hours)	112	112
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
User Fee Website Survey Supporting Statement	User_Fee_Website_Survey.doc	09/29/2014

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