Jac And Jaccis Customer Satisfaction 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⚠️ Notice: This information collection may be referencing outdated material.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 1601-0014 can be found here:

Documents and Forms

Document Name Document Type
Form DHS Form 0041 JAC AND JACCIS CUSTOMER SATISFACTION SURVEY Form
DHS Form 0041 JAC Survey DHS Form 0041-JAC Survey.pdf Form
JAC Satisfaction Generic Clearance Submission.docx Generic IC submission form IC Document
JAC Survey Email Cover Letter.docx Email to Respondents IC Document

Information Collection (IC) Details

IC Title:	JAC AND JACCIS CUSTOMER SATISFACTION 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	DHS Form 0041	JAC Survey	DHS Form 0041-JAC Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 750	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	750	750
Annual IC Time Burden (Hours)	188	188
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic IC submission form	JAC Satisfaction Generic Clearance Submission.docx	08/20/2015
Email to Respondents	JAC Survey Email Cover Letter.docx	08/20/2015

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