View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	COSWD Activity Satisfaction Survey (OD)	Agency IC Tracking Number:

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	1	Survey	Attachment 1_COSWD_Instrument.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	600	0	600	0	0	0
Annual IC Time Burden (Hours)	100	0	100	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Template	Template COSWD_Request.docx	05/03/2023
Listserv Announcement	Attachment 2_COSWD_Listserv Survey Announcement_ Initial_Followup-5.2.docx	05/03/2023
Listserv Template	Attachment 3_COSWD_Listserv Survey Template_5.2.docx	05/03/2023
Blog and Event Announcement	Attachment 4_COSWD_Blog and Event Chat Survey Announcement_5.2.docx	05/03/2023

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