User feedback revised Office of Climate Change and Health Equity website

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Documents and Forms

Document Name Document Type
UXdraft.docx Other-Qualitative data collection in
Qualitativesubmission_memo.docx Memo IC Document

Information Collection (IC) Details

IC Title:	User feedback revised Office of Climate Change and Health Equity website	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
Other-Qualitative data collection instrument/process			UXdraft.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 15 %

	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Memo	Qualitativesubmission_memo.docx	03/22/2024

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