Information Collection

Customer Satisfaction Survey for CWIG - Revision

IC 208654 under ICR 201211-0970-002 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Customer Satisfaction Survey for CWIG - Revision

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.