View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	FSR 247 DOD Air Force, FSR 248 HHS CMS FCSO J9 MAC, FSR 249 CitizenFeedback	Agency IC Tracking Number:	FSR 247, FSR 248, FSR 249

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	FSR 247	DOD Air Force questionnaire	FSR 247 DOD Air Force.xls		Yes	Yes	Fillable Fileable
Form	FSR 248	HHS CMS FCSO J9 MAC questionnaire	FSR 248 HHS CMS FCSO J9 MAC.xls		Yes	Yes	Fillable Fileable
Form	FSR 249	Citizen Feedback Questionnaire	FSR 249 CitizenFeedback Questionaire.xls		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	1,300	0	1,300	0	0	0
Annual IC Time Burden (Hours)	54	0	54	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for ICs to generic ICR 1505-0186	Justification for ICs to generic ICR 1505-0186.doc	02/20/2009

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