Utility Cost Data Survey (Req-21)

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⚠️ Notice: This information collection may be referencing outdated material.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
Instrument-3090-0297 Utility Cost Data Survey (Req-21).pdf Other-Survey
Template-3090-0297 Utility Cost Data Survey (Req-21).docx Template Utility Cost Data Survey (Req-21) IC Document

Information Collection (IC) Details

IC Title:	Utility Cost Data Survey (Req-21)	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			Instrument-3090-0297 Utility Cost Data Survey (Req-21).pdf		Yes	Yes	Fillable Printable

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Template Utility Cost Data Survey (Req-21)	Template-3090-0297 Utility Cost Data Survey (Req-21).docx	07/15/2015

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