WiTS Climate Survey 2015

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⚠️ Notice: This information collection may be referencing outdated material.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 WiTS Climate Survey 2015 Form and Instruction
1 2015 WiTS Climate Survey 2015_WiTS_Climate_Survey (3).docx Form and Instruction
1 2015 WiTS Climate Survey 2015_WiTS_Climate_Survey (3).docx Form and Instruction
FT Template_WiTS Climate Surveys.docx FT WiTS Climate Survey IC Document
FT Template_WiTS Climate Surveys.docx FT WiTS Climate Survey IC Document

Information Collection (IC) Details

IC Title:	WiTS Climate Survey 2015	Agency IC Tracking Number:

IC Status: Unchanged

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	2015 WiTS Climate Survey	2015_WiTS_Climate_Survey (3).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FT WiTS Climate Survey	FT Template_WiTS Climate Surveys.docx	02/16/2018

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