View Information Collection (IC)

View Information Collection (IC)

IC Title:	User Satisfaction Surevy for MICAD Users	Agency IC Tracking Number:

IC Status: Unchanged

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	Survey for MICAD Users screenshots	MICAD_survey_sceenshots_7_18_2012[1].pdf		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	300	0	0	0	0	300
Annual IC Time Burden (Hours)	10	0	0	0	0	10
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Mini Supporting Statement	MICAD 2012 - NLM Mini-Supporting Statement_ML Surveys_MICAD Users August 2012 FINAL.doc	08/15/2012
Generic Clearance Request Form	MICAD 2012 - NLM Generic Clearance Request Form_MICAD Survey July 2012.doc	08/15/2012

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