Standards Reference Materials (SRM) - Customer Satisfaction Data Collection

Generic Clearance for Customer Service-Related Data Collections

0693-0031_SurveyMonkey_SRMRegistrationQuestions_SAMPLE_2024_Submission

Standards Reference Materials (SRM) - Customer Satisfaction Data Collection

OMB: 0693-0031

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NIST	Standard	Reference	Material	(SRM)	Registration	System
NIST	SRM	Registration	System

The	NIST	SRM	Registration	System	allows	you	to	receive	notification	of
any	developments	or	updates	to	that	product.	Notification	requires	the
SRM	user’s	contact	information.
This	 collection	 of	 information	 contains	 Paperwork	 Reduction	 Act	 (PRA)	 requirements	 approved	 by	 the	 Office	 of
Management	and	Budget	(OMB).	Notwithstanding	any	other	provisions	of	the	law,	no	person	is	required	to	respond
to,	nor	shall	any	person	be	subject	to	a	penalty	for	failure	to	comply	with,	a	collection	of	information	subject	to	the
requirements	 of	 the	 PRA	 unless	 that	 collection	 of	 information	 displays	 a	 currently	 valid	 OMB	 control	 number.
Public	 reporting	 burden	 for	 this	 collection	 is	 estimated	 to	 be	 7	 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.	 Comments	 regarding	 this	 burden	 estimate	 or	 any	 aspect	 of	 this
collection	of	information,	including	suggestions	for	reducing	this	burden,	may	be	sent	to	the	following:
National	Institute	of	Standards	and	Technology
Attn:	Tracy	Hayat
Office	of	Reference	Materials
100	Bureau	Drive,	Stop	2300
Gaithersburg,	MD	20899-2300
Tel:	301-975-2092	E-mail:	tracy.hayat@nist.gov
**Disclaimer**
You	 are	 accessing	 a	 U.S.	 Government	 information	 system,	 which	 includes:	 1)	 this	 computer,	 2)	 this	 computer
network,	3)	all	computers	connected	to	this	network,	and	4)	all	devices	and	storage	media	attached	to	this	network
or	 to	 a	 computer	 on	 this	 network.	 You	 understand	 and	 consent	 to	 the	 following:	 you	 may	 access	 this	 information
system	 for	 authorized	 use	 only;	 you	 have	 no	 reasonable	 expectation	 of	 privacy	 regarding	 any	 communication	 of
data	 transiting	 or	 stored	 on	 this	 information	 system;	 at	 any	 time	 and	 for	 any	 lawful	 Government	 purpose,	 the
Government	may	monitor,	intercept,	and	search	and	seize	any	communication	or	data	transiting	or	stored	on	this
information	 system;	 and	 any	 communications	 or	 data	 transiting	 or	 stored	 on	 this	 information	 system	 may	 be
disclosed	or	used	for	any	lawful	Government	purpose.

OMB	Control	No.:	0693-0031					OMB	Expiration	Date:	August	31,	2024

NIST	Standard	Reference	Material	(SRM)	Registration	System
SRM	User	Contact	Information

*	NIST	SRM	User	Information		(Fields	with	an	asterisk	are	required.)
*User	First	Name:
*User	Surname:
*Organization/Compan
y:
*Address:
Address	(continued):
*City:
*State/Province:
Postal	Code:
*Country:

*	Email	Address	(Required	to	be	completed;	field	should	contain	an	@	symbol	and	a	period.)

NIST	Standard	Reference	Material	(SRM)	Registration	System
Fields	with	an	asterisk	(*)	are	required.

*	Purchased	directly	from	NIST?
Yes
No
Unkown

NIST	Standard	Reference	Material	(SRM)	Registration	System
Fields	with	an	asterisk	(*)	are	required.

*	(1)	NIST	SRM	Information
(1)	SRM/RM	Number:

(1)	NIST	SRM	Information	(continued)
(1)	Lot	Number	(if
available):
(1)	Serial	Number	(if
available):

(2)	NIST	SRM	Information
(2)	SRM/RM	Number:

(2)	NIST	SRM	Information	(continued)
(2)	Lot	Number	(if
available):
(2)	Serial	Number	(if
available):

(3)	NIST	SRM	Information
(3)	SRM/RM	Number:

(3)	NIST	SRM	Information	(continued)
(3)	Lot	Number	(if
available):
(3)	Serial	Number	(if
available):

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(1)	designates	the	first	SRM	you	are	registering.	Fields	with	an	asterisk	(*)	are
required.

*	(1)	NIST	SRM	Information	(Required	to	be	completed.)
(1)	SRM/RM	Number:

(1)	NIST	SRM	Information	(continued)
(1)	Lot	Number	(if
available):
(1)	Serial	Number	(if
available):

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(1)	designates	the	first	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(1)	Purchased	from	(Company	Name)

(1)	Order	Date	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(1)	designates	the	first	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(1)	Purchase	Information	(NIST)
(1)	Order	Date
(MM/DD/YYYY):
(1)	NIST	Sales	Order:
(1)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(2)	designates	the	second	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(2)	NIST	SRM	Information
(2)	SRM	Number
Purchased:

(2)	NIST	SRM	Information	(continued)
(2)	Lot	Number	(if
available):
(2)	Serial	Number	(if
available):

*	(2)	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(2)	designates	the	second	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(2)	Purchased	from	(Company	Name)

(2)	Order	Date	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(2)	designates	the	second	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(2)	Purchase	Information	(NIST)
(2)	Order	Date
(MM/DD/YYYY):
(2)	NIST	Sales	Order:
(2)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(3)	designates	the	third	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(3)	NIST	SRM	Information
(3)	SRM	Number
Purchased:

(3)	NIST	SRM	Information	(continued)
(3)	Lot	Number	(if
available):
(3)	Serial	Number	(if
available):

*	(3)	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(3)	designates	the	third	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(3)	Purchased	from	(Company	Name):

(3)	Order	Date	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(3)	designates	the	third	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(3)	Purchase	Information	(NIST)
(3)	Order	Date
(MM/DD/YYYY):
(3)	NIST	Sales	Order:
(3)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(4)	designates	the	fourth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(4)	NIST	SRM	Information
(4)	SRM	Number
Purchased:

(4)	NIST	SRM	Information	(continued)
(4)	Lot	Number	(if
available):
(4)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(4)	designates	the	fourth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(4)	Purchased	from	(Company	Name)

(4)	Order	Date	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(4)	designates	the	fourth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(4)	Purchase	Information	(NIST)
(4)	Order	Date
(MM/DD/YYYY):
(4)	NIST	Sales	Order
Number:
(4)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(5)	designates	the	fifth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(5)	NIST	SRM	Information
(5)	SRM	Number
Purchased:

(5)	NIST	SRM	Information	(continued)
(5)	Lot	Number	(if
available):
(5)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(5)	designates	the	fifth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(5)	Purchased	from	(Company	Name):

(5)	Order	Date	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(5)	designates	the	fifth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(5)	Purchase	Information	(NIST)
(5)	Order	Date
(MM/DD/YYYY):
(5)	NIST	Sales	Order
Number:
(5)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(6)	designates	the	sixth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(6)	NIST	SRM	Information
(6)	SRM	Number
Purchased:

(6)	NIST	SRM	Information	(continued)
(6)	Lot	Number	(if
available):
(6)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(6)	designates	the	sixth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(6)	Purchased	from	(Company	Name):

*	(6)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(6)	designates	the	sixth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(6)	Purchase	Information	(NIST)
(6)	Order	Date
(MM/DD/YYYY):
(6)	NIST	Sales	Order
Number:
(6)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(7)	designates	the	seventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(7)	NIST	SRM	Information
(7)	SRM	Number
Purchased:

(7)	NIST	SRM	Information	(continued)
(7)	Lot	Number	(if
available):
(7)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(7)	designates	the	seventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(7)	Purchased	from	(Company	Name):

*	(7)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(7)	designates	the	seventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(7)	Purchase	Information	(NIST)
(7)	Order	Date
(MM/DD/YYYY):
(7)	NIST	Sales	Order
Number:
(7)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(8)	designates	the	eighth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(8)	NIST	SRM	Information
(8)	SRM	Number
Purchased:

(8)	NIST	SRM	Information	(continued)
(8)	Lot	Number	(if
available):
(8)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(8)	designates	the	eighth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(8)	Purchased	from	(Company	Name):

*	(8)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(8)	designates	the	eighth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(8)	Purchase	Information	(NIST)
(8)	Order	Date
(MM/DD/YYYY):
(8)	NIST	Sales	Order
Number:
(8)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(9)	designates	the	ninth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(9)	NIST	SRM	Information
(9)	SRM	Number
Purchased:

(9)	NIST	SRM	Information	(continued)
(9)	Lot	Number	(if
available):
(9)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(9)	designates	the	ninth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(9)	Purchased	from	(Company	Name):

*	(9)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(9)	designates	the	ninth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(9)	Purchase	Information	(NIST)
(9)	Order	Date
(MM/DD/YYYY):
(9)	NIST	Sales	Order
Number:
(9)	Customer	Purchase
Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(10)	designates	the	tenth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(10)	NIST	SRM	Information
(10)	SRM	Number
Purchased:

(10)	NIST	SRM	Information	(continued)
(10)	Lot	Number	(if
available):
(10)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(10)	designates	the	tenth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(10)	Purchased	from	(Company	Name):

*	(10)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(10)	designates	the	tenth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)	are
required.

*	(10)	Purchase	Information	(NIST)
(10)	Order	Date
(MM/DD/YYYY):
(10)	NIST	Sales	Order
Number:
(10)	Customer
Purchase	Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(11)	designates	the	eleventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(11)	NIST	SRM	Information
(11)	SRM	Number
Purchased:

(11)	NIST	SRM	Information	(continued)
(11)	Lot	Number	(if
available):
(11)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(11)	designates	the	eleventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(11)	Purchased	from	(Company	Name):

*	(11)	Order	Date:		(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(11)	designates	the	eleventh	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(11)	Purchase	Information	(NIST)
(11)	Order	Date
(MM/DD/YYYY):
(11)	NIST	Sales	Order
Number:
(11)	Customer
Purchase	Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(12)	designates	the	twelfth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(12)	NIST	SRM	Information
(12)	SRM	Number
Purchased:

(12)	NIST	SRM	Information	(continued)
(12)	Lot	Number	(if
available):
(12)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(12)	designates	the	twelfth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(12)	Purchased	from	(Company	Name):

*	(12)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(12)	designates	the	twelfth	SRM	you	are	registering.		Fields	with	an	asterisk	(*)
are	required.

*	(12)	Purchase	Information	(NIST)
(12)	Order	Date
(MM/DD/YYYY):
(12)	NIST	Sales	Order
Number:
(12)	Customer
Purchase	Order:

*	Would	you	like	to	register	another	NIST	SRM?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(13)	designates	the	thirteenth	SRM	you	are	registering.		Fields	with	an	asterisk
(*)	are	required.

*	(13)	NIST	SRM	Information
(13)	SRM	Number
Purchased:

(13)	NIST	SRM	Information	(continued)
(13)	Lot	Number	(if
available):
(13)	Serial	Number	(if
available):

*	Purchased	directly	from	NIST?
Yes
No

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(13)	designates	the	thirteenth	SRM	you	are	registering.		Fields	with	an	asterisk
(*)	are	required.

*	(13)	Purchased	from	(Company	Name):

*	(13)	Order	Date:	(If	not	known,	please	approximate	with	the	month	and	year.)

*
You	have	reached	your	SRM	limit	for	this	registration	form.	Click	"Submit	Registration"	and
then	click	"Continue"	to	confirm	and	complete	your	registration.	If	you	have	additional	SRMs
to	 register,	 please	 open	 up	 a	 new	 registration	 form.	 	 The	 SRM	 Registration	 System	 link	 is
provided	on	the	next	page.
Submit	Registration

NIST	Standard	Reference	Material	(SRM)	Registration	System
A	(13)	designates	the	thirteenth	SRM	you	are	registering.	Fields	with	an	asterisk
(*)	are	required.

*	(13)	Purchase	Information	(NIST)
(13)	Order	Date
(MM/DD/YYYY):
(13)	NIST	Sales	Order
Number:
(13)	Customer
Purchase	Order:

NIST	Standard	Reference	Material	(SRM)	Registration	System
Copy	of	page:	A	(13)	designates	the	thirteenth	SRM	you	are	registering.	Fields	with
an	asterisk	(*)	are	required.

*
You	have	reached	your	SRM	limit	for	this	registration	form.	Click	"Submit	Registration"	and
then	click	"Submit"	to	confirm	and	complete	your	registration.	If	you	have	additional	SRMs	to
register,	 please	 open	 up	 a	 new	 registration	 form.	 The	 SRM	 Registration	 System	 link	 is
provided	on	the	next	page.
Submit	Registration


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