Workstyle Survey

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⚠️ Notice: This information collection may be referencing outdated material.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
NIH_Rockledge_WorkstyleSurveyEmail_DRAFT_11-14-16.docx Other-Survey Email
1 Qualtrics Print Qualtrics Print 11-15-16.pdf Form and Instruction
NIH Workstyle Survey Fast-track template 2016-mods1.doc Workstyle Survey IC Document

Information Collection (IC) Details

IC Title:	Workstyle Survey	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
Other-Survey Email			NIH_Rockledge_WorkstyleSurveyEmail_DRAFT_11-14-16.docx		Yes	Yes	Fillable Fileable
Form and Instruction	1	Qualtrics Print	Qualtrics Print 11-15-16.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	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	300	300
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Workstyle Survey	NIH Workstyle Survey Fast-track template 2016-mods1.doc	11/15/2016

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