Peer Review

Generic Clearance for Satisfaction Surveys of Customers (CSR)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0474 can be found here:

Documents and Forms

Document Name Document Type
Form 2 Peer Review Form and Instruction
2 survey 20090821 Attachment 2 - Reviewer Survey Instrument 8-25.doc Form and Instruction
1 survey 20090821 Attachment 1 - Applicant Survey Instrument 8-25.doc Form and Instruction
0925-0474 generic_clearance_form 8-25.doc 0925-0474 generic_clearance_form 8-25 IC Document
20090821 OMB Mini Supporting Statements A B 8-25.doc 20090821 OMB Mini Supporting Statements A B 8-25 IC Document

Information Collection (IC) Details

IC Title:	Peer Review	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 and Instruction	2	survey	20090821 Attachment 2 - Reviewer Survey Instrument 8-25.doc		Yes	Yes	Paper Only
Form and Instruction	1	survey	20090821 Attachment 1 - Applicant Survey Instrument 8-25.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,769	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	3,769	0	0	0	0	0
Annual IC Time Burden (Hours)	942	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
0925-0474 generic_clearance_form 8-25	0925-0474 generic_clearance_form 8-25.doc	08/25/2009
20090821 OMB Mini Supporting Statements A B 8-25	20090821 OMB Mini Supporting Statements A B 8-25.doc	08/25/2009

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