American Customer Satisfaction Index

Forms and Documents

Document Name	Status
Form CFI 197 CFI 197 DOC NOAA NWS Climate Services, CFI 198 USDA FSA Form	New
Form CFI 190 CFI 190, CFI 191, CFI 192, CFI 193, CFI 194, CFI 195, CFI 196 Form	New
Form CFI 188 CFI 188 HHS NCI Live Help, CFI 189 VA VHA CHAMPVA Form	New
Form CFI 185 CFI 182 CNS Senior Corps, CFI 183 CNS Learn & Serve, CFI 184 CNS State and Local Grantees, CFI 185 VISTA, CFI 186 DHS USCIS E-Verify, CFI 187 DHS USCIS Form	New
Form CFI 180 CFI 180 HHS OCS Assets for Independence, CFI 181 State BCA Passport Services Form	New
Form CFI 179 CFI 179 TREAS IRS Opera Form	New
Form CFI 175 CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient Form	New
Form CFI 172 CFI 171 DOC NOAA NWS Hydrology Program, CFI 172 USDA Marketing Service, CFI 173 NASA EOSDIS Form	New
Form CFI 169 CFI 169 DOJ COPS Grantees, CFI 170 DOJ COPS Publications and Training Form	New
Form CFI 164 CFI 164 Domestic Investigative Reports, CFI 165 BSA E-Filing System, CFI 166 Foreign Investigative Reports, CFI 167 Treas FINCEN Proactive Investigative Reports, CFI 168 SAR Activity Review Form	New
Form CFI 158 CFI 158 DOT FAA AVS Mechanics, CFI 163 USDA ERS publications Form	New
Form CFI 159 CFI 159 USDA ERS Food Security information users, CFI 160 EEOC NCC and FO, CFI 161 USDA NRCS CSI, CFI 162 USDA NRCS EQIP nonsuccessful Form	New
Form CFI 155 CFI 155 DOT FAA AVS Commercial Pilots, CFI 156 USDA FAS, CFI 157 DOD DTIC, CFI 158 DOT FAA AVS Mechanics Form	New
Form CFI 154 CFI 151 DOT FAA FSS, CFI 152 TREAS FINCEN Beneficial Ownership, CFI 153 USDA FAS Direct Loan Approved, CFI 154 USDA FAS Direct Loan Declined Form	New
Form CFI 150 CFI 150 USDA NRRS Customer Support Form	New
Form CFI 148 CFI 146 Treas FinCEN Secure Outreach, CFI 147 Treas FinCEN Compliance MOU, CFI 148 Treas FinCEN Regulatory Resource Center, CFI 149 Treas FinCEN Foreign Technical Assistance Form	New
Form CFI 144 CFI 144 DOC ITA MAC, CFI 145 TREAS FINCEN CBFT Form	New
Form CFI 142 CFI 141 USDA NASS, CFI 142 VA Outpatient, CFI 143 VA Inpatient Form	New
Form CFI 140 CFI 140 USDA NRRS Form	New
Form CFI 139 CFI 139 US Mint Form	New
Form CFI 138 CFI 138 DOD USACE Form	New
Form CFI 130 CFI 130 TREAS IRS SBSE, CFI 131 TREAS IRS Paper Filers, CFI 132 TREAS IRS OPERA, CFI 133 TREAS IRS LMSB, CFI 134 TREAS IRS E-FIler, CFI 137 DOT FAA AO Form	New
Form CFI 124 CFI 124 CNS Learn and Serve, CFI 125 CNS NCCC, CFI 126 CNS Senior Corps, CFI 127 CNS VISTA Form	New
Form CFI 128 CFI 128 SBA ODA, CFI 129 DOC MBDA, CFI 135 DOT FAA ATO, CFI 136 NASA EODIS Form	New
Form CFI 123 CFI 123 CNS Americorps State and National Form	New
Form CFI 122 CFI 122 GSA FCIC Form	New
Justification for Non-Material Change 1505-0191.doc Justification for No Material/Nonsubstantive Change	2007-07-05

IC Document Collections

IC ID	Document Title	Status
188565	CFI 197 DOC NOAA NWS Climate Services, CFI 198 USDA FSA Form	New
187976	CFI 190, CFI 191, CFI 192, CFI 193, CFI 194, CFI 195, CFI 196 Form	New
187666	CFI 188 HHS NCI Live Help, CFI 189 VA VHA CHAMPVA Form	New
187258	CFI 182 CNS Senior Corps, CFI 183 CNS Learn & Serve, CFI 184 CNS State and Local Grantees, CFI 185 VISTA, CFI 186 DHS USCIS E-Verify, CFI 187 DHS USCIS Form	New
186907	CFI 180 HHS OCS Assets for Independence, CFI 181 State BCA Passport Services Form	New
186582	CFI 179 TREAS IRS Opera Form	New
186197	CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient Form	New
185783	CFI 171 DOC NOAA NWS Hydrology Program, CFI 172 USDA Marketing Service, CFI 173 NASA EOSDIS Form	New
185645	CFI 169 DOJ COPS Grantees, CFI 170 DOJ COPS Publications and Training Form	New
185432	CFI 164 Domestic Investigative Reports, CFI 165 BSA E-Filing System, CFI 166 Foreign Investigative Reports, CFI 167 Treas FINCEN Proactive Investigative Reports, CFI 168 SAR Activity Review Form	New
185363	CFI 158 DOT FAA AVS Mechanics, CFI 163 USDA ERS publications Form	New
184847	CFI 159 USDA ERS Food Security information users, CFI 160 EEOC NCC and FO, CFI 161 USDA NRCS CSI, CFI 162 USDA NRCS EQIP nonsuccessful Form	New
184647	CFI 155 DOT FAA AVS Commercial Pilots, CFI 156 USDA FAS, CFI 157 DOD DTIC, CFI 158 DOT FAA AVS Mechanics Form	New
184440	CFI 151 DOT FAA FSS, CFI 152 TREAS FINCEN Beneficial Ownership, CFI 153 USDA FAS Direct Loan Approved, CFI 154 USDA FAS Direct Loan Declined Form	New
184226	CFI 150 USDA NRRS Customer Support Form	New
183321	CFI 146 Treas FinCEN Secure Outreach, CFI 147 Treas FinCEN Compliance MOU, CFI 148 Treas FinCEN Regulatory Resource Center, CFI 149 Treas FinCEN Foreign Technical Assistance Form	New
182903	CFI 144 DOC ITA MAC, CFI 145 TREAS FINCEN CBFT Form	New
182649	CFI 141 USDA NASS, CFI 142 VA Outpatient, CFI 143 VA Inpatient Form	New
182353	CFI 140 USDA NRRS Form	New
182260	CFI 139 US Mint Form	New
182014	CFI 138 DOD USACE Form	New
181368	CFI 130 TREAS IRS SBSE, CFI 131 TREAS IRS Paper Filers, CFI 132 TREAS IRS OPERA, CFI 133 TREAS IRS LMSB, CFI 134 TREAS IRS E-FIler, CFI 137 DOT FAA AO Form	New
181295	CFI 124 CNS Learn and Serve, CFI 125 CNS NCCC, CFI 126 CNS Senior Corps, CFI 127 CNS VISTA Form	New
181294	CFI 128 SBA ODA, CFI 129 DOC MBDA, CFI 135 DOT FAA ATO, CFI 136 NASA EODIS Form	New
181227	CFI 123 CNS Americorps State and National Form	New
181205	CFI 122 GSA FCIC Form	New

ICR Details

OMB Control No: 1505-0191	ICR Reference No: 200707-1505-001
Status: Historical Active	Previous ICR Reference No: 200604-1505-001
Agency/Subagency: TREAS/DO	Agency Tracking No:
Title: American Customer Satisfaction Index
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/13/2007
	Date Received in OIRA: 07/05/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2009	08/31/2009	08/31/2009
Responses	117,000	0	117,000
Time Burden (Hours)	23,400	0	23,400
Cost Burden (Dollars)	0	0	0

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Abstract: The objectives of surveying citizen users of Federal Agencies as part of the American Customer Satisfaction Index are: (1) to make the agencies part of a national measure of customer satisfaction; (2) to benchmark against other agencies and companies; and (3) to provide information for improving customer satisfaction.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 26

IC Title	Form No.	Form Name
CFI 122 GSA FCIC	CFI 122	GSA FCIC Questionnaire
CFI 123 CNS Americorps State and National	CFI 123	CNS Americorps State and National
CFI 141 USDA NASS, CFI 142 VA Outpatient, CFI 143 VA Inpatient	CFI 141, CFI 143, CFI 142	VA Outpatient Questionnaire ,   VA Inpatient questionnaire ,   USDA NASS questionnaire
CFI 139 US Mint	CFI 139	US Mint
CFI 144 DOC ITA MAC, CFI 145 TREAS FINCEN CBFT	CFI 144, CFI 145	DOC ITA MAC ,   TREAS FINCEN CBFT
CFI 190, CFI 191, CFI 192, CFI 193, CFI 194, CFI 195, CFI 196	CFI 191, CFI 192, CFI 194, CFI 196, CFI 195, CFI 193 , CFI 190	USDA Forest Service questionnaire ,   TREAS FINCEN Compliance MOU questionnaire ,   TREAS FINCEN Foreign Technical Assistance ,   TREAS FINCEN Regulatory Resource Center questionnaire ,   TREAS FINCEN Secure Outreach ,   HHS CMS IVR questionnaire ,   HHS CMS Customer Representative questionnaire
CFI 197 DOC NOAA NWS Climate Services, CFI 198 USDA FSA	CFI 197, CFI 198	DOC NOAA NWS Climate Services ,   USDA FSA
CFI 158 DOT FAA AVS Mechanics, CFI 163 USDA ERS publications	CFI 158, CFI 163	DOT FAA AVS Mechanics questionnaire - revised ,   USDA ERS Publications questionnaire
CFI 175 ED NCES, CFI 176 DOT FAA ATO, CFI 177 DOD Tricare Outpatient, CFI 178 DOD Tricare Inpatient	CFI 177, CFI 175, CFI 176 , CFI 178	ED NCES questionnaire ,   DOT FAA ATO questionnaire ,   DOD Tricare Outpatient questionnaire ,   DOD Tricare Inpatient
CFI 128 SBA ODA, CFI 129 DOC MBDA, CFI 135 DOT FAA ATO, CFI 136 NASA EODIS	CFI 128, CFI 129, CFI 135, CFI 136	SBA ODA ,   DOC MBDA ,   DOT FAA ATO ,   NASA EOSDIS
CFI 151 DOT FAA FSS, CFI 152 TREAS FINCEN Beneficial Ownership, CFI 153 USDA FAS Direct Loan Approved, CFI 154 USDA FAS Direct Loan Declined	CFI 154, CFI 152, CFI 151, CFI 152	USDA FSA Direct Farm Loans Declined ,   DOT FAA FSS ,   TREAS FinCEN Beneficial Ownership ,   USDA FSA Direct Farm Loans Approved
CFI 180 HHS OCS Assets for Independence, CFI 181 State BCA Passport Services	CFI 181, CFI 180	HHS OCS Assets for Independence questionnaire ,   State BCA Passport Services questionnaire
CFI 182 CNS Senior Corps, CFI 183 CNS Learn & Serve, CFI 184 CNS State and Local Grantees, CFI 185 VISTA, CFI 186 DHS USCIS E-Verify, CFI 187 DHS USCIS	CFI 186, CFI 187, CFI 182, CFI 183, CFI 184, CFI 185	CNS VISTA questionnaire ,   DHS USCIS E-Verify questionnaire ,   DHS USCIS CSI questionnaire ,   CNS Senior Corps questionnaire ,   CNS Learn and Serve questionnaire ,   CNS State and National Grantees questionnaire
CFI 169 DOJ COPS Grantees, CFI 170 DOJ COPS Publications and Training	CFI 169, CFI 170	DOJ COPS Grantees ,   DOJ COPS Publications and Training
CFI 130 TREAS IRS SBSE, CFI 131 TREAS IRS Paper Filers, CFI 132 TREAS IRS OPERA, CFI 133 TREAS IRS LMSB, CFI 134 TREAS IRS E-FIler, CFI 137 DOT FAA AO	CFI 133 , CFI 130 , CFI 131 , CFI 132 , CFI 134 , CFI 137 DOT FAA OA	TREAS IRS SBSE ,   TREAS IRS Paper Filers ,   TREAS IRS OPERA ,   TREAS IRS LMSB ,   TREAS IRS E-Filer ,   DOT FAA OA
CFI 138 DOD USACE	CFI 138	DOD USACE
CFI 150 USDA NRRS Customer Support	CFI 150	USDA NRRS Customer Supoprt
CFI 171 DOC NOAA NWS Hydrology Program, CFI 172 USDA Marketing Service, CFI 173 NASA EOSDIS	CFI 172, CFI 173	USDA Marketing News ,   NASA EOSDIS questionnaire
CFI 164 Domestic Investigative Reports, CFI 165 BSA E-Filing System, CFI 166 Foreign Investigative Reports, CFI 167 Treas FINCEN Proactive Investigative Reports, CFI 168 SAR Activity Review	CFI 166, CFI 168, CFI 167, CFI 165, CFI 164	TREAS FINCEN Domestic Invest Case Reports questionnaire ,   TREAS FINCEN BSA E-Filing ,   TREAS FINCEN Foreign Invest Case Reports ,   TREAS FINCEN Proactive Invest Target Reports ,   TREAS FINCEN SAR Activity Review
CFI 155 DOT FAA AVS Commercial Pilots, CFI 156 USDA FAS, CFI 157 DOD DTIC, CFI 158 DOT FAA AVS Mechanics	CFI 157, CFI 155, CFI 156	DOT FAA AVS Commercial Pilots ,   USDA FAS ,   DOD DTIC
CFI 146 Treas FinCEN Secure Outreach, CFI 147 Treas FinCEN Compliance MOU, CFI 148 Treas FinCEN Regulatory Resource Center, CFI 149 Treas FinCEN Foreign Technical Assistance	CFI 147, CFI 148, CFI 149, CFI 146	TREAS FINCEN Regulatory Resource Center ,   TREAS FINCEN Foreign Technical Assistance ,   TREAS FINCEN Secure Outreach ,   TREAS FINCEN Compliance MOU
CFI 124 CNS Learn and Serve, CFI 125 CNS NCCC, CFI 126 CNS Senior Corps, CFI 127 CNS VISTA	CFI 126 , CFI 127 , CFI 124, CFI 125	CNS Learn and Serve ,   CNS NCCC ,   CNS Senior Corps ,   CNS VISTA
CFI 179 TREAS IRS Opera	CFI 179	TREAS IRS Opera questionnaire
CFI 140 USDA NRRS	CFI 140	USDA NRRS questionnaire
CFI 159 USDA ERS Food Security information users, CFI 160 EEOC NCC and FO, CFI 161 USDA NRCS CSI, CFI 162 USDA NRCS EQIP nonsuccessful	CFI 159, CFI 160, CFI 161 , CFI 162	USDA ERS Food Security information users ,   EEOC NCC and FO ,   USDA NRCS CSI ,   USDA NRCS non-successful
CFI 188 HHS NCI Live Help, CFI 189 VA VHA CHAMPVA	CFI 189, CFI 188	HHS NCI Live Help questionnaire ,   VA VHA CHAMPVA questionnaire

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	117,000	117,000	0	0	0	0
Annual Time Burden (Hours)	23,400	23,400	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/05/2007

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