View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[OADC] CDC DDT Recipient Satisfaction Survey	Agency IC Tracking Number:	0920-1050-23EU

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	CDC 1815/1817 Recipient Satisfaction Survey	CDC DDT Recipient Satisfaction Survey_Attachment 2.docx	NA	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: 120	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	120	0	120	0	0	0
Annual IC Time Burden (Hours)	10	0	10	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	GenIC Clearance Form_Recipient Satisfaction Survey .docx	05/08/2023
Email Invitation	CDC DDT Recipient Satisfaction Survey_Attachment 3.docx	05/08/2023

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