Feedback USA Button

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
Feedback USA Collection Instrument.docx Other-Feed Back Button
Feedback USA Sample Question(s).docx Other-Feed Back Sample Questions
Federal Feedback Button General Clearance 10 15 2015.docx Feedback USA General Clearance IC Document

Information Collection (IC) Details

IC Title:	Feedback USA Button	Agency IC Tracking Number:	2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.9

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Feed Back Button			Feedback USA Collection Instrument.docx		Yes	Yes	Printable Only
Other-Feed Back Sample Questions			Feedback USA Sample Question(s).docx		Yes	Yes	Printable Only

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,920	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,920	1,920
Annual IC Time Burden (Hours)	128	128
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Feedback USA General Clearance	Federal Feedback Button General Clearance 10 15 2015.docx	10/16/2015

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