Customer Satisfaction and Usability of Technical Packages for Violence Prevention

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

OMB: 0920-1009

IC ID: 227884

Documents and Forms
Document Name
Document Type
Other-WORD
Other-Screenshots
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Customer Satisfaction and Usability of Technical Packages for Violence Prevention 0920-1009 (17AYY)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att. A Instrument.docx Yes Yes Paper Only
Other-Screenshots Att. B DVP Screenshot.docx Yes Yes Fillable Fileable

Health Health Care Services

 

2,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,000 0 2,000 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval Request GenIc DVP-TP.docx 08/10/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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