STC Los Angeles/Long Beach Regional Stakeholder 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⚠️ Notice: This information collection may be referencing outdated material.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 10093 STC Los Angeles/Long Beach Regional Stakeholder Survey Form
DHS Form 10093 STC Member Questionnaire STC LA LB Questionnaire_FINAL.pdf Form
STC_ Survey_Clearance_Submission_FINAL.pdf Gen IC Mini Supporting Statement IC Document
DHS-ALL-PIA-006.pdf Privacy Documentation IC Document

Information Collection (IC) Details

IC Title:	STC Los Angeles/Long Beach Regional Stakeholder 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 10093	STC Member Questionnaire	STC LA LB Questionnaire_FINAL.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: 18	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Gen IC Mini Supporting Statement	STC_ Survey_Clearance_Submission_FINAL.pdf	01/26/2016
Privacy Documentation	DHS-ALL-PIA-006.pdf	01/19/2016

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