CIS OMBudsman 2015 Annual Conference Evaluation 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⚠️ Notice: This information collection may be referencing outdated material.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 1601-0014 can be found here:

Documents and Forms

Document Name Document Type
CIS Ombudsman 2015 Annual Conference Evaluation Form Form
2015 CIS Ombudsman Annual Conference Feedback Form CISOMB AnnualConference Feedback Form.pdf Form
CISOMB 2015 Annual Conference Feedback Form_Submission Form.docx Mini Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	CIS Ombudsman 2015 Annual Conference Evaluation 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
Form	n/a	2015 CIS Ombudsman Annual Conference Feedback Form	CISOMB AnnualConference Feedback Form.pdf		Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

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: 0 %

	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

Title	Document	Date Uploaded
Mini Supporting Statement	CISOMB 2015 Annual Conference Feedback Form_Submission Form.docx	10/05/2015

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