NITAAC Customer Feedback Questionnaire (OD)

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⚠️ Notice: This information collection may be referencing outdated material.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 NITAAC Customer Feedback Questionnaire (OD) Form and Instruction
1 NITAAC Survey NITAAC Survey.pdf Form and Instruction
1 NITAAC Survey NITAAC Survey.pdf Form and Instruction
Fast-Track - NITAAC 360 Survey_Agency_Stakeholders.docx Fast track request NITAAC 360 Survey Agency Stakeholders IC Document
Fast-Track - NITAAC 360 Survey_Agency_Stakeholders.docx Fast track request NITAAC 360 Survey Agency Stakeholders IC Document
Govt Email.docx Govt email IC Document
Govt Email.docx Govt email IC Document

Information Collection (IC) Details

IC Title:	NITAAC Customer Feedback Questionnaire (OD)	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	NITAAC Survey	NITAAC Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast track request NITAAC 360 Survey Agency Stakeholders	Fast-Track - NITAAC 360 Survey_Agency_Stakeholders.docx	01/30/2020
Govt email	Govt Email.docx	01/30/2020

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