DVR Cutomer Service Survey - Animal Services

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⚠️ Notice: This information collection may be referencing outdated material.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 DVR Cutomer Service Survey - Animal Services Form
1 Animal Services Survey 031717-FINAL-FY17 Animal Services Survey.docx Form
031717-FINAL-PRA-Letter-DVR Animal Services Survey (2).docx PRA Letter DVR Animal Services IC Document
031717-FINAL-Animal Services Request for OMB Survey Approval.docx Animal Services Fast track template IC Document

Information Collection (IC) Details

IC Title:	DVR Cutomer Service Survey - Animal Services	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	1	Animal Services Survey	031717-FINAL-FY17 Animal Services Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	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	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PRA Letter DVR Animal Services	031717-FINAL-PRA-Letter-DVR Animal Services Survey (2).docx	03/20/2017
Animal Services Fast track template	031717-FINAL-Animal Services Request for OMB Survey Approval.docx	04/06/2017

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