Information Collection

CIS OMBudsman 2015 Annual Conference Evaluation Form

IC 218500 under ICR 201410-1601-003 · OMB 1601-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

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
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.