View Information Collection Request (ICR) Package

OMB Control No: 0935-0106	ICR Reference No: 200409-0935-002
Status: Historical Active	Previous ICR Reference No: 200202-0935-001
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Voluntary Customer Surveys Generic Clearance for the Agency for Healthcare Research and Quality
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/03/2005
	Date Received in OIRA: 09/30/2004
Terms of Clearance: Approved consistent with AHRQ memo submitted to OMB 12/08/04 detailing Privacy Act Language that will accompany collections under this generic clearance as appropriate. This generic collection is approved on the following conditions :(1) AHRQ must seek and receive OMB approval for each individual survey prior to using the survey in the field. (2) AHRQ will provide a discussion of any proposed incentives and Privacy Act Requirements in each submission under this generic (3) AHRQ will provide the total approved burden, the requested burden, and the total burden currently in use under the generic clearance with each submission. OMB will review requests under this clearance within 10 days of submission and will either approve requested collections or provide questions and comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2008	01/31/2008	12/31/2004
Responses	103,400	0	112,800
Time Burden (Hours)	16,356	0	20,667
Cost Burden (Dollars)	515,732,000	0	515,732,000

Abstract: Surveys will assess strengths and weaknesses of agency program services including querying individuals using AHRQ paper and electronic products to determine satisfaction with form and content or to assess effects of streamlining efforts.

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Voluntary Customer Surveys Generic Clearance for the Agency for Healthcare Research and Quality

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	103,400	112,800	-9,400
Annual Time Burden (Hours)	16,356	20,667	-4,311
Annual Cost Burden (Dollars)	515,732,000	515,732,000	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

View ICR - OIRA Conclusion