Information Collection

Survey of Customer Satisfaction for DCCPS Fellows

IC 224280 under ICR 201406-0925-004 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Survey of Customer Satisfaction for DCCPS Fellows Form
1 Fellows Survey Screenshot Fellows Survey_Screenshots_11.1.16 (1).docx Form
Fast Track DCCPS Fellows.docx Fast Track DCCPS Fellows IC Document
Email Invite for Fellows Customer Satisfaction Survey.docx Email Invite for Fellows Customer Satisfactory Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey of Customer Satisfaction for DCCPS Fellows	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	1	Fellows Survey Screenshot	Fellows Survey_Screenshots_11.1.16 (1).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track DCCPS Fellows	Fast Track DCCPS Fellows.docx	11/01/2016
Email Invite for Fellows Customer Satisfactory Survey	Email Invite for Fellows Customer Satisfaction Survey.docx	11/01/2016

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