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

View Information Collection (IC)

CDC-INFO Web-based Satisfaction Survey (for Individual Respondents Who Send Email Inquiries) 0920-1050-22CD-5
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1050 Email Survey Questionnaire 2022 CDC-INFO Email Survey_v3_final.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

1,600 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 1,600 0 1,600 0 0 0
Annual IC Time Burden (Hours) 187 0 187 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Email Survey (Individual) - Spanish 2022 CDC-INFO Email Survey_v3-SPANISH_final.docx 04/14/2022
GenIC Request Template Generic Clearance Submission Template_2022_Email Survey_Individual Respondents_re final.docx 04/14/2022
Email Survey Screenshot - 1 CDC-INFO_Email_Survey Monkey Screenshot_Image 1.PNG 04/14/2022
Email Survey Screenshot - 2 CDC-INFO_Email_Survey Monkey Screenshot_Image 2.PNG 04/14/2022
Email Survey Screenshot - 3 CDC-INFO_Email_Survey Monkey Screenshot_Image 3.PNG 04/14/2022
Email Survey Screenshot - 1 - Spanish CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 1.PNG 04/14/2022
Email Survey Screenshot - 2 - Spanish CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 2.PNG 04/14/2022
Email Survey Screenshot - 3 - Spanish CDC-INFO_Email_SPANISH_Survey Monkey Screenshot_Image 3.PNG 04/14/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.