View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	2023 ITSS Employee Feedback Survey	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	0925-0648	2023 ITSS Employee Feedback Survey Collection Instrument	2023 ITSS Employee Feedback Survey Collection 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: 32	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	32	0	32	0	0	0
Annual IC Time Burden (Hours)	5	0	5	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Email Correspondence	2023 ITSS Employee Feedback Survey Additional Supporting Document.docx	12/08/2023
Template	CIT 2023 ITSS Employee Feedback Survey Fast Track Form.docx	12/08/2023

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