409 VHA ChampVA 2011 Q's, 410 DOJ COPS TTA , 411PBGC Participant Caller ACSI Instrument 2011 FINAL, 412PBGC Retiree ACSI Instrument 2011 FINAL, 413MINT ACSI Annual Customer Satisfaction Survey FINAL

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 409 VHA ChampVA 20 409 VHA ChampVA 2011 Q's, 410 DOJ COPS TTA , 411PBGC Participant Caller ACSI Instrument 2011 FINAL, 412PBGC Retiree ACSI Instrument 2011 FINAL, 413MINT ACSI Annual Customer Satisfaction Survey FINAL Form
409 VHA ChampVA 20 409 VHA ChampVA 2011 Q's 2011 409 VHA ChampVA 2011 Questionnaire Final.doc Form
410 DOJ COPS TTA R 410 DOJ COPS TTA Recip_Quart_FY2011_FINAL 2011 410 DOJ COPS TTA Recip_Quart_FY2011_FINAL.docx Form
411 PBGC Participa 411 PBGC Participant Caller ACSI Instrument 2011 FINAL 2011 411 Participant Caller ACSI Instrument 2011 FINAL.doc Form
412 PBGC Retiree A 412 PBGC Retiree ACSI Instrument 2011 FINAL 2011 412 Retiree ACSI Instrument 2011 FINAL.DOC Form
413 MINT ACSI Annu 413 MINT ACSI Annual Customer Satisfaction Survey FINAL 2011 413 ACSI Annual Customer Satisfaction Survey FINAL Mar9.docx Form

Information Collection (IC) Details

IC Title:	409 VHA ChampVA 2011 Q's, 410 DOJ COPS TTA , 411PBGC Participant Caller ACSI Instrument 2011 FINAL, 412PBGC Retiree ACSI Instrument 2011 FINAL, 413MINT ACSI Annual Customer Satisfaction Survey FINAL	Agency IC Tracking Number:	409-413

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	409 VHA ChampVA 2011 Q's	409 VHA ChampVA 2011 Q's	2011 409 VHA ChampVA 2011 Questionnaire Final.doc	No		Paper Only
Form	410 DOJ COPS TTA Recip_Quart_FY2011_FINAL	410 DOJ COPS TTA Recip_Quart_FY2011_FINAL	2011 410 DOJ COPS TTA Recip_Quart_FY2011_FINAL.docx	Yes	Yes	Fillable Fileable
Form	411 PBGC Participant Caller ACSI Instrument 2011 F	411 PBGC Participant Caller ACSI Instrument 2011 FINAL	2011 411 Participant Caller ACSI Instrument 2011 FINAL.doc	No		Paper Only
Form	412 PBGC Retiree ACSI Instrument 2011 FINAL	412 PBGC Retiree ACSI Instrument 2011 FINAL	2011 412 Retiree ACSI Instrument 2011 FINAL.DOC	No		Paper Only
Form	413 MINT ACSI Annual Customer Satisfaction Survey	413 MINT ACSI Annual Customer Satisfaction Survey FINAL Mar9	2011 413 ACSI Annual Customer Satisfaction Survey FINAL Mar9.docx	No		Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	208	208
Annual IC Cost Burden (Dollars)	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.