Satisfaction Survey for Child Welfare Information Gateway

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Satisfaction Survey for Child Welfare Information Gateway Form
1 Individuals/Households General Customer Survey_5.31.12_Personal.docx Form
1 Questions for Students General Customer Survey_questions for students.docx Form
1 Questions for Professionals General Customer Survey_questions for professionals.docx Form
Fast Track submission_CUSTOMER SURVEY_5.31.12_rev.doc Request IC Document

Information Collection (IC) Details

IC Title:	Satisfaction Survey for Child Welfare Information Gateway	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Individuals/Households	General Customer Survey_5.31.12_Personal.docx	Yes	Yes	Fillable Fileable
Form	1	Questions for Students	General Customer Survey_questions for students.docx	Yes	Yes	Fillable Printable
Form	1	Questions for Professionals	General Customer Survey_questions for professionals.docx	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,434	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,434	2,434
Annual IC Time Burden (Hours)	159	159
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request	Fast Track submission_CUSTOMER SURVEY_5.31.12_rev.doc	06/13/2012

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