SCSEP Employer and Host Agency Customer Satisfaction Surveys

Senior Community Service Employment Program (SCSEP) Performance Measurement System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0040 can be found here:

Documents and Forms

Document Name Document Type
HOST AGENCY Survey ETA-9124B_9 13 10.pdf Other-survey
EMPLOYER Survey ETA-9124C_9 13 10.pdf Other-survey

Information Collection (IC) Details

IC Title:	SCSEP Employer and Host Agency Customer Satisfaction Surveys	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Part 641 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			HOST AGENCY Survey ETA-9124B_9 13 10.pdf		No		Paper Only
Other-survey			EMPLOYER Survey ETA-9124C_9 13 10.pdf		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,700	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	15,700	-1,700	17,400
Annual IC Time Burden (Hours)	2,617	877	1,740
Annual IC Cost Burden (Dollars)	0	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.