Information Collection

EBSA Participant Assistance Program Customer Survey

IC 214415 under ICR 201304-1225-001 · OMB 1225-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EBSA_CE11_FY15_ SURVEY 12-18-14.docx	Other-Phone Survey
Approval.pdf OCEO Approval for Statistical Methods	IC Document
EBSA Customer Satisfaction Study PRA Package Part A.pdf EBSA Participant Assistance Program Customer Survey Justification Part A	IC Document
EBSA Customer Satisfaction Study Part B 12172014 CEO final.docx EBSA Customer Satisfaction Study PRA Package Part B Statistical Methods	IC Document

IC Title:

EBSA Participant Assistance Program Customer Survey

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
Other-Phone Survey			EBSA_CE11_FY15_ SURVEY 12-18-14.docx		No		Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,000

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 Agency Discretion
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	1,467	1,467
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OCEO Approval for Statistical Methods	Approval.pdf	12/23/2014
EBSA Participant Assistance Program Customer Survey Justification Part A	EBSA Customer Satisfaction Study PRA Package Part A.pdf	12/23/2014
EBSA Customer Satisfaction Study PRA Package Part B Statistical Methods	EBSA Customer Satisfaction Study Part B 12172014 CEO final.docx	12/23/2014

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