Booker T. Washington National Monument Formative Exhibition Evaluation Survey

DOI Programmatic Clearance for Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1040-0001 can be found here:

Documents and Forms

Document Name Document Type
BOWA Principal e-mail.docx Other-Email survey
BOWA Youth Questionnaire 3-8-2012.doc Other-Questionnaire
BOWA Adult Questionnaire 3-9-2012.docx Other-Questionnaire
Justification for BOWA 3-9-2012.docx Justification for BOWA Questionnaires IC Document
BOWA_EvalLog_v1.pdf Evaluation Observation Log IC Document
BOWA Evaluation Scripts 3-9-2012.docx BOWA Evaluation Scripts IC Document

Information Collection (IC) Details

IC Title:	Booker T. Washington National Monument Formative Exhibition Evaluation Survey	Agency IC Tracking Number:	CSS-10

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Email survey	BOWA Principal e-mail.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire	BOWA Youth Questionnaire 3-8-2012.doc	No		Paper Only
Other-Questionnaire	BOWA Adult Questionnaire 3-9-2012.docx	No		Paper Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 194	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 1 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	194	194
Annual IC Time Burden (Hours)	86	86
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for BOWA Questionnaires	Justification for BOWA 3-9-2012.docx	03/09/2012
Evaluation Observation Log	BOWA_EvalLog_v1.pdf	03/09/2012
BOWA Evaluation Scripts	BOWA Evaluation Scripts 3-9-2012.docx	03/09/2012

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