View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[NCHS] Customer Satisfaction Survey of NCHS DQS Application Users in 2025.	Agency IC Tracking Number:	0920-25-0080

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	0920-25-0080	Attachment A- 2025 DQS Application User Survey_Final	Attachment A- 2025 DQS Application User Survey_Final.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	500	0	500	0	0	0
Annual IC Time Burden (Hours)	83	0	83	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Determination	Attachment B - NCHS_DQS_CustomerSurveys_CRdetermination_03192025.pdf	04/09/2025
SSA	Sup St A Application Survey Final V4.docx	04/09/2025
SSA	Sup St A Application Survey Final V4.docx	04/09/2025
SSB	Sup St B Application Survey Final V3.docx	04/09/2025

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