Information Collection

Examination Survey

IC 32785 under ICR 200609-3133-004 · OMB 3133-0144.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3133-0144 Examination Survey Examination Survey	Form and Instruction
3133-0144 Examination Survey 0144, Cover Letter& Survey2006.pdf	Form and Instruction

IC Title:

Examination Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3133-0144				Yes	Yes	Fillable Fileable

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,391

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,391	-632	6,023
Annual IC Time Burden (Hours)	449	-53	502
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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