Information Collection

SCSEP Participant Customer Satisfaction Survey

IC 180161 under ICR 201103-1205-009 · OMB 1205-0040.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ETA 9124A SCSEP Participant Customer Satisfaction Survey	Form and Instruction
ETA 9124A Participant Customer Satisfaction Survey PARTICIPANT Survey ETA-9124A_9 13 10.pdf	Form and Instruction

IC Title:

SCSEP Participant Customer Satisfaction Survey

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9124A	Participant Customer Satisfaction Survey	PARTICIPANT Survey ETA-9124A_9 13 10.pdf		Yes	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: 17,500

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	17,500	3,500	14,000
Annual IC Time Burden (Hours)	1,750	350	1,400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.