Information Collection

Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC)

IC 218892 under ICR 201406-0925-004 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC)	Form and Instruction
1 Attachment 1 OMPC Survey Attach1_OMPC Survey_10-21-2015_Rev.pdf	Form and Instruction
OMPC Fast-track template.doc Fast Track Submission Form	IC Document

IC Title:

Customer Satisfaction Survey for the Office of Management Policy and Compliance (OMPC)

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
Form and Instruction	1	Attachment 1 OMPC Survey	Attach1_OMPC Survey_10-21-2015_Rev.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Submission Form	OMPC Fast-track template.doc	11/06/2015

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