Preclearance Field Office U.S. Domestic Airport Stakeholder Feedback Form

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⚠️ Notice: This information collection may be referencing outdated material.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 1651-0136 can be found here:

Documents and Forms

Document Name Document Type
Attachment B - Survey HTML.pdf Other-Survey
Preclearance Survey Fast Track Submission.pdf Fast Track Survey Request IC Document
Attachment A - List of Targeted Respondents.pdf List of Respondents IC Document
Attachment B - Survey HTML.pdf Survey IC Document
Attachment C - Draft Email to Invite Survey Participation.pdf Email invite for survey IC Document
Attachment D - Draft Email Follow Up to Invite Survey Participation.pdf Follow-up email for survey IC Document

Information Collection (IC) Details

IC Title:	Preclearance Field Office U.S. Domestic Airport Stakeholder Feedback Form	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
Other-Survey			Attachment B - Survey HTML.pdf		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 131	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	131	131
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Survey Request	Preclearance Survey Fast Track Submission.pdf	05/17/2016
List of Respondents	Attachment A - List of Targeted Respondents.pdf	05/17/2016
Survey	Attachment B - Survey HTML.pdf	05/17/2016
Email invite for survey	Attachment C - Draft Email to Invite Survey Participation.pdf	05/17/2016
Follow-up email for survey	Attachment D - Draft Email Follow Up to Invite Survey Participation.pdf	05/17/2016

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