Information Collection

Design for Accessibility Needs Assessment Survey

IC 204205 under ICR 201301-3135-001 · OMB 3135-0130.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3135-0130 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Design for Accessibility Needs Assessment Survey Form and Instruction
1 Design for Accessibility Needs Assessment Survey NEA DFA Needs Assessment Survey.pdf Form and Instruction
General Clearance Form Accessibiity.pdf General Clearance Form Accessibiity IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Design for Accessibility Needs Assessment Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	Design for Accessibility Needs Assessment Survey	NEA DFA Needs Assessment Survey.pdf		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: 366	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	366	366
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
General Clearance Form Accessibiity	General Clearance Form Accessibiity.pdf	09/26/2012

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