Rocky Mountain Lab - Family Care Survey 2019 (ORS/OD)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Rocky Mountain Lab - Family Care Survey 2019 (ORS/OD) Form and Instruction
1 RML Family Care Survey Screenshot 040419-GB-AB-RML Family Care Survey-Screenshots.pdf Form and Instruction
040419-GB-AB-RML Family Care Survey-PRA Request.doc RML Family Care Survey fast track IC Document
040419-ABestor-Email-RML Childcare Survey.docx email to RML childcare survey IC Document

Information Collection (IC) Details

IC Title:	Rocky Mountain Lab - Family Care Survey 2019 (ORS/OD)	Agency IC Tracking Number:

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	1	RML Family Care Survey Screenshot	040419-GB-AB-RML Family Care Survey-Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RML Family Care Survey fast track	040419-GB-AB-RML Family Care Survey-PRA Request.doc	04/10/2019
email to RML childcare survey	040419-ABestor-Email-RML Childcare Survey.docx	04/10/2019

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