Feedback Block for FEMP Website

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5160 can be found here:

Documents and Forms

Document Name Document Type
Feedback Block Screenshot FEMP.docx Other-Survey
OMB_clearance form_feedback_FEMP_3 4 14.doc Generic Clearance Form - Feedback Block FEMP IC Document

Information Collection (IC) Details

IC Title:	Feedback Block for FEMP Website	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-Survey			Feedback Block Screenshot FEMP.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Form - Feedback Block FEMP	OMB_clearance form_feedback_FEMP_3 4 14.doc	04/03/2014

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