ClinRegs Pop-up Survey Questions (NIAID)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0668 can be found here:

Documents and Forms

Document Name Document Type
Form 1 ClinRegs Pop-up Survey Questions (NIAID) Form
1 Survey Mock-up Survey Mock Up for PRA Submission-08-21-20.pdf Form
Fast Track Template 2020-Pop-up survey for submission_08-21-20.docx fast track 2020 Pop-up survey IC Document

Information Collection (IC) Details

IC Title:	ClinRegs Pop-up Survey Questions (NIAID)	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	1	Survey Mock-up	Survey Mock Up for PRA Submission-08-21-20.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
fast track 2020 Pop-up survey	Fast Track Template 2020-Pop-up survey for submission_08-21-20.docx	08/25/2020

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