Customer Satisfaction Survey for CWIG - Revision

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⚠️ Notice: This information collection may be referencing outdated material.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 Customer Satisfaction Survey for CWIG - Revision Form and Instruction
1 Survey General Customer Survey_rev FY 14_sent to OMB 9 11 13.docx Form and Instruction
Fast Track submission_CUSTOMER SURVEY_sent to OMB 9 11 13.doc Request IC Document

Information Collection (IC) Details

IC Title:	Customer Satisfaction Survey for CWIG - Revision	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
Form and Instruction	1	Survey	General Customer Survey_rev FY 14_sent to OMB 9 11 13.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,267	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	2,267	0	0	0	0	0
Annual IC Time Burden (Hours)	145	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request	Fast Track submission_CUSTOMER SURVEY_sent to OMB 9 11 13.doc	09/13/2013

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