Customer Assessment Survey

Voluntary Customer Surveys in Accordance with E.O. 12862

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0192 can be found here:

Documents and Forms

Document Name Document Type
Form G-201 (08-03) Customer Assessment Survey Form and Instruction
G-201 (08-03) Customer Assessment Survey G-201 (08-03).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Customer Assessment Survey	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
Form and Instruction	G-201 (08-03)	Customer Assessment Survey	G-201 (08-03).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 180

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	180	0	0	0	0	0
Annual IC Time Burden (Hours)	6	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

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.