Design for Accessibility Needs Assessment Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

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.