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Federal forms, ICRs, and supporting documents

Information Collection Request

VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN THE INDIAN HEALTH SERVICE

ICR 199312-0917-001 · OMB 0917-0018 · Historical Active

Forms and Documents
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IC Document Collections
IC IDCollectionTypeStatusForm
110468 VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN THE INDIAN HEALTH SERVICE Migrated
ICR Details
0917-0018 199312-0917-001
Historical Active
HHS/IHS
VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN THE INDIAN HEALTH SERVICE
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/21/1993
Retrieve Notice of Action (NOA) 12/10/1993
We have approved this set of customer surveys to be conducted by the Indian Health Service.
  Inventory as of this Action Requested Previously Approved
12/31/1996 12/31/1996
48,843 0 0
8,140 0 0
0 0 0
THESE VOLUNTARY CUSTOMER SURVEYS WILL BE USED TO IMPLEMENT E.O. 12862 TO ASCERTAIN CUSTOMER SATISFACTION WITHIN THE INDIAN HEALTH SERVICE IN TERMS OF TIMELINESS, APPROPRIATENESS, ACCESS, AND OTHER MEASURES OF SERVICE QUALITY. SURVEYS WILL INVOLVE INDIVIDUALS THAT ARE THE DIRECT OR INDIRECT BENEFICIARIES OF IHS SERVICES OF ASSISTANCE, NOT
None
None
No
1
IC Title Form No. Form Name
VOLUNTARY CUSTOMER SURVEYS TO IMPLEMENT EXECUTIVE ORDER 12862 WITHIN THE INDIAN HEALTH SERVICE
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 48,843 0 0 48,843 0 0
Annual Time Burden (Hours) 8,140 0 0 8,140 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/10/1993