Omnibus 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⚠️ Notice: This information collection may be referencing outdated material.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 0420-0545 can be found here:

Documents and Forms

Document Name Document Type
Form Omnibus Survey 1 Omnibus Survey Form
Omnibus Survey 1 Omnibus Survey Questions Candidate_Omnibus_Questions_FINAL.doc Form
OMB_Clearance_Submission__for_Omnibus_FINAL.docx Omnibus Survey Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Omnibus Survey	Agency IC Tracking Number:

IC Status: New

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	Omnibus Survey 1	Omnibus Survey Questions	Candidate_Omnibus_Questions_FINAL.doc		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Omnibus Survey Supporting Statement	OMB_Clearance_Submission__for_Omnibus_FINAL.docx	07/29/2014

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