AVS Techmnical Assistance Evaluation Form

OMB # 1029-0114

Expiration Date: 3/31/2011

AVS TECHNICAL ASSISTANCE EVALUATION FORM

The Lexington Applicant Violator System Office within the Office of Surface Mining recently provided you with assistance. To help us to assess the quality of our services under the Federal Government Performance and Results Act, please take a few moments to fill out this evaluation form. Your response, which is voluntary and confidential, will help us to better serve you in the future.

TYPE OF ASSISTANCE WE PROVIDED:

[ ] Permit Eligibility Reports from AVS

(Goal: Provide responses to states and others to verify information in the AVS within 2 business days after receiving the request or  business day for abandoned mine land emergencies)

[ ] Requests for Information from AVS

(Goal: Provide information within 2 business days following request)

[ ] Ownership/Control Updates for Interstate Mining Companies

(Goal: Complete within 5 business days)

[ ] AVS Computer Support (Ad hoc reports; provide system access or technical assistance for system access )

(Goal: Provide requested information within 5 business days)

[ ] Investigative Assistance on Ownership/Control Issues

(Goal: Make initial investigative contact within 2 business days)

(Please Circle)

1=Poor 5= Excellent

1) Was our assistance timely? 1 2 3 4 5

2) How do you rate the quality of our assistance? 1 2 3 4 5

3) Did we treat you professionally and courteously? 1 2 3 4 5

4) How can we improve our service to you?

Please return in the enclosed stamped, addressed envelope to:

Office of Surface Mining

2679 Regency Road Or fax to: 859-260-8418

Lexington, KY 40503 Or e-mail your response to: [email protected]

PAPERWORK REDUCTION ACT STATEMENT

The Paperwork Reduction Act of 1995 (44 U.S.C. 3501) requires us to inform you that: Federal Agencies may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. This information is being collected to better serve you in the future and as part of OSM's performance of its responsibilities under the Government Performance and Results Act. The obligation to respond is voluntary.

Public reporting burden for this form is estimated to average 5 minutes per response, including time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Office of Surface Mining Reclamation and Enforcement, Room 202 SIB, 1951 Constitution Ave, NW, Washington, D.C. 20240.