Mobile Survey-Req-2

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (GSA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3090-0297 can be found here:

Documents and Forms

Document Name Document Type
3090-0297-Mobile Survey_Sept_2011-Instrument-REQ-2.doc Other-Mobile Survey
3090-0297-Mobile Survey_Sept_2011-Template-Responses-REQ-2-.doc Mobile Survey-REQ-2 IC Document

Information Collection (IC) Details

IC Title:	Mobile Survey-Req-2	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-Mobile Survey			3090-0297-Mobile Survey_Sept_2011-Instrument-REQ-2.doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mobile Survey-REQ-2	3090-0297-Mobile Survey_Sept_2011-Template-Responses-REQ-2-.doc	11/16/2011

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