View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

414 ePSS, 415 FCIC 11Feb2011, 416 FCIC Pueblo 11Feb2011, 417 Howto.gov 3.7.2011 , 418 NLM Clinical Trials, 419 CMS Palmetto GBA J11 MAC, 420 Recreation.gov 2-4-2011 to 3-25-11, 421 DHHS-PSC , 422 DOT 414-422
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 414 ePSS Questionnaire Wave 1 Revised 414 ePSS Questionnaire Wave 1 Revised 2011 414 ePSS Questionnaire Wave 1 Revised.xlsx Yes Yes Fillable Fileable
Form 415 FCIC Consumer Action CQ revisions_11Feb2011 415 FCIC Consumer Action CQ revisions_11Feb2011 2011 415 FCIC Consumer Action CQ revisions_11Feb2011.xlsx Yes Yes Fillable Fileable
Form 416 FCIC Pueblo Survey revisions_11Feb2011 416 FCIC Pueblo Survey revisions_11Feb2011 2011 416 FCIC Pueblo Survey revisions_11Feb2011.xlsx Yes Yes Fillable Fileable
Form 417 Howto.gov Survey 3.7.2011 - current 417 Howto.gov Survey 3.7.2011 - current 2011 417 Howto.gov Survey 3.7.2011 - current.xlsx Yes Yes Fillable Fileable
Form 418 NLM Clinical Trials Questionnaire _2-14-11 418 NLM Clinical Trials Questionnaire _2-14-11 2011 418 NLM Clinical Trials Questionnaire _2-14-11.xls Yes Yes Fillable Fileable
Form 419 CMS Palmetto GBA J11 MAC Questionnaire 3-10-11 419 CMS Palmetto GBA J11 MAC Questionnaire 3-10-11 2011 419 CMS Palmetto GBA J11 MAC Questionnaire 3-10-11.xlsx Yes Yes Fillable Fileable
Form 420 CQs for OMB 2-4-2011 to 3-25-11 420 CQs for OMB 2-4-2011 to 3-25-11 2011 420 CQs for OMB 2-4-2011 to 3-25-11.xlsx Yes Yes Fillable Fileable
Form 421 DHHS-PSC Offline Services Q's 02-25-11 421 DHHS-PSC Offline Services Questionnaire 02-25-11 2011 421 DHHS-PSC Offline Services Questionnaire 02-25-11.xlsx Yes Yes Fillable Fileable
Form 422 DOT FHWA Questionnaire 02-17-2011 422 DOT FHWA Questionnaire 02-17-2011 2011 422 DOT FHWA Questionnaire 02-17-2011.xlsx Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt

 

45,000 0
   
Individuals or Households
 
   100 %

  Approved 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 45,000 0 45,000 0 0 0
Annual IC Time Burden (Hours) 1,875 0 1,875 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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