The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material.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 The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees Form and Instruction
LRP Referee Survey - Invitation Email 2.docx Other-Invitation Email
1 LRP Referee Survey- Screenshots LRP Referee Survey - Screenshots 2.pdf Form and Instruction
LRP Referee Survey - PCB Fasttrack Template 2.doc The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees IC Document

Information Collection (IC) Details

IC Title:	The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees	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	LRP Referee Survey- Screenshots	LRP Referee Survey - Screenshots 2.pdf		Yes	Yes	Fillable Fileable
Other-Invitation Email			LRP Referee Survey - Invitation Email 2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,120	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	3,120	3,120
Annual IC Time Burden (Hours)	104	104
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
The NIH Extramural Loan Repayment Programs: Online Post-Application Customer Service Survey for Recommenders/Referees	LRP Referee Survey - PCB Fasttrack Template 2.doc	11/09/2016

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