Information Collection

EBSA Participant Assistance Program Customer Survey

IC 196043 under ICR 200909-1225-001 · OMB 1225-0059.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

EBSA Participant Assistance Program Customer Survey

Agency IC Tracking Number:

IC Status: New

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
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 %

table that charts list of burden
	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

table that charts IC Documents
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.