User Insights for NCHHSTP Atlas Website and Tool Review _Online Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Document Name Document Type
Att 1_Atlas Survey Screenshots.docx Other-Screenshots
Att 2_Atlas Invite.docx Other-WORD
ReqforAppv_Atlas Survey_FastTrack.docx Request for Approval_Atlas Survey IC Document

Information Collection (IC) Details

IC Title:	User Insights for NCHHSTP Atlas Website and Tool Review _Online Survey	Agency IC Tracking Number:	16JL

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-Screenshots			Att 1_Atlas Survey Screenshots.docx		Yes	Yes	Fillable Fileable
Other-WORD			Att 2_Atlas Invite.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval_Atlas Survey	ReqforAppv_Atlas Survey_FastTrack.docx	01/13/2016

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