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

View Information Collection (IC)

ServiceNow Case/Incident Survey --Req. 4
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Incident Mockup.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

540 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 540 0 540 0 0 0
Annual IC Time Burden (Hours) 27 0 27 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ServiceNow Incident Survey_A-11 Incident ICR_A11 Section 280 Clearance (2) (1).docx 04/18/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.