Web-based Survey of DIRLINE database (NLM)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Web-based Survey of DIRLINE database (NLM) Form and Instruction
1 NLM Survey Instument NLM DIRLINE_survey instrument_fast track request (2).docx Form and Instruction
NLM DIRLINE_NIH_fast_track_template request 12.28.12.doc Fast Track Request Template IC Document
NLM DIRLINE_Survey_screenshot_fast track request (2).pdf Fats Track Request Instrument Screenshots IC Document

Information Collection (IC) Details

IC Title:	Web-based Survey of DIRLINE database (NLM)	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	1	NLM Survey Instument	NLM DIRLINE_survey instrument_fast track request (2).docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	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: 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	150	0	0	0	0	0
Annual IC Time Burden (Hours)	13	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Request Template	NLM DIRLINE_NIH_fast_track_template request 12.28.12.doc	07/06/2012
Fats Track Request Instrument Screenshots	NLM DIRLINE_Survey_screenshot_fast track request (2).pdf	07/06/2012

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