BLS Clearance Form

u.s. DEPARTMENT OF LABOR
Bureau of Labor Statistics Concurrence of Customer Satisfaction Surveys Employing
Statistical Methods
TO:

FAX:

DATE:

Kathy Downey

202-691-7382

[Enter program sponsor contact]
FROM:

/

/

PHONE

John Eltinge
202-691-7404
[Enter name ofBLS reviewer]
ACTION: Review the attached report proposal, indicate approval or disapproval and return to
the Sponsoring agency or program. Comments shall not be made on the proposed report but in
the comments space below.
TITLE OF SURVEY OR EVALUATION
Employment

Projections

Program User Survey

Disapproved (See comments below)
Approved with caveats (See comments below)
COMMENTS
Think! Privacy Act
(Insert additional pages as needed)

(Attach sheet if additional space is necessary)
Disclaimer: BLS is approving only the statistical
necessarily passing judgment on the questionnaire
information.

methodology
as presented
itself nor on the necessity

in the written documentation,
to conduct the collection of

~/

and not

DATE
11 /:{~p
DL-]-150A

(Rev. 5/03)