View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Customer Satisfaction Survey for CDC AR Isolate Bank Year 2	Agency IC Tracking Number:	0920-1071-17AUB

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	none	AR Isolate Bank Survey	AR Isolate Bank - Customer Satisfaction Survey Items Yr2 v3.docx		Yes	Yes	Fillable Fileable

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: 405	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 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	405	0	405	0	0	0
Annual IC Time Burden (Hours)	68	0	68	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	AR Isolate Bank - Service Delivery Fast Track Template_v4_2017_06_26.docx	06/28/2017

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