Information Collection

NIOSH Customer Satisfaction Survey - Short/Intermediary

IC 229156 under ICR 201711-0920-003 · OMB 0920-0544.

Documents and Forms

Document Name Document Type
Form 0920-0544 NIOSH Customer Satisfaction Survey - Short/Intermediary Form and Instruction
0920-0544 CSI Survey Shortl Intermediary Version Att 3c Short Intermediary.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NIOSH Customer Satisfaction Survey - Short/Intermediary	Agency IC Tracking Number:

Is this a Common Form? No		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 and Instruction	0920-0544	CSI Survey Shortl Intermediary Version	Att 3c Short Intermediary.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 375	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	375	375
Annual IC Time Burden (Hours)	31	31
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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