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Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0970-0401
IC ID: 275040
OMB.report
HHS/ACF
OMB 0970-0401
ICR 202504-0970-024
IC 275040
( )
Documents and Forms
Document Name
Document Type
Both_Standard Feedback Survey for the NCHBHS TTA Offerings_2.4.25 clean (1).docx
Other-Survey
OMB form_revised Standard Survey_1.12.22-clean.docx
Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings
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
Both_Standard Feedback Survey for the NCHBHS TTA Offerings_2.4.25 clean (1).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
63,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
63,000
0
63,000
0
0
0
Annual IC Time Burden (Hours)
5,250
0
5,250
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Submission Form - Standard Feedback Survey for the NCHBHS TTA Offerings
OMB form_revised Standard Survey_1.12.22-clean.docx
04/25/2025
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.