EBSA Participant Assistance Program Customer Survey

Customer Satisfaction Surveys and Conference Evaluations Generic Clearance

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0059 can be found here:

Documents and Forms

Document Name Document Type
EBSA Customer Satisfaction Survey(20101209).docx Other-telephone survey
OMB Clearance Package Final(20110125).pdf Supporting Statement IC Document
OMB Clearance Package Final(20110125).pdf BLS Concurrence, Form DL-1-150A IC Document

Information Collection (IC) Details

IC Title:	EBSA Participant Assistance Program Customer Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-telephone survey			EBSA Customer Satisfaction Survey(20101209).docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,336	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,336	6,336
Annual IC Time Burden (Hours)	845	845
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	OMB Clearance Package Final(20110125).pdf	02/01/2011
BLS Concurrence, Form DL-1-150A	OMB Clearance Package Final(20110125).pdf	02/01/2011

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