Information Collection

Customer Satisfaction - Ind / Households

IC 43726 under ICR 200804-0970-001 · OMB 0970-0303.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0303 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Customer Satisfaction - Ind / Households	Form and Instruction
1 Cust Individuals Appendix B_IC1 Customer Satisfaction Survey_Individuals.doc	Form and Instruction

IC Title:

Customer Satisfaction - Ind / Households

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	1	Cust Individuals	Appendix B_IC1 Customer Satisfaction Survey_Individuals.doc		No	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,208

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 76 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,208	-290	1,498
Annual IC Time Burden (Hours)	94	-83	177
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.