Regional Discussion Follow Up Evaluation

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

0704-0553_Scheduler Survey Instrument_4.21.2020

Regional Discussion Follow Up Evaluation

OMB: 0704-0553

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OMB CONTROL NUMBER: 0704-0553

OMB EXPIRATION DATE: XX/XX/XXXX


AGENCY DISCLOSURE NOTICE


The public reporting burden for this collection of information, 0704-0553, is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.


Instructions


Thank you again for volunteering to provide further detail on the regional discussion. We look forward to speaking with you. Please provide the top five dates and times that work best for your schedule as well as your preferred contact number or e-mail. We will reach out to you with the confirmed date for your follow up phone call.

Date and Time

  1. (fill in)

  2. (fill in)

  3. (fill in)

  4. (fill in)

  5. (fill in)

Preferred Phone or E-mail where you would like us to provide your scheduled date (fill in)

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSvec, Leedjia A LCDR SAPRO
File Modified0000-00-00
File Created2021-01-14

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