2019 NIOSH Centers Grantee Meeting Evaluation Survey

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

⚠️ Notice: This information collection may be referencing outdated material.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
2019 NIOSH Centers Grantee Meeting Evaluation Survey Form
Grantee Meeting Evaluation NIOSH Centers Grantee Meeting Evaluation.docx Form
Fast_Track_GenIC_RequestTemplate_9.17.19.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	2019 NIOSH Centers Grantee Meeting Evaluation Survey	Agency IC Tracking Number:	0920-0953-19BRQ

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	none	Grantee Meeting Evaluation	NIOSH Centers Grantee Meeting Evaluation.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 89	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	89	89
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	Fast_Track_GenIC_RequestTemplate_9.17.19.docx	09/17/2019

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