View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[OS NCCDPHP] Award Management Platform Customer Satisfaction Surveys-Division of Oral Health	Agency IC Tracking Number:	0920-1050 -23CJ

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 and Instruction	0920-1050	DOH TA Satisfaction Survey	Attachment 5- DOH AMP TA Satifaction Survey_Updated Flow_AMP revisions_10312020.docx	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 47	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	47	0	47	0	0	0
Annual IC Time Burden (Hours)	2	0	2	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Template 0920-1050	Attachment 1- Customer Service GenIC Clearance Template (Final 5.3) AMP CSS.docx	02/09/2023

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