Feedback USA Button Pilot

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⚠️ Notice: This information collection may be referencing outdated material.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 1615-0121 can be found here:

Documents and Forms

Document Name Document Type
September 2016 - Feedback on USA Button.docx Other-Survey
Mini - Supporting Statement - Feedback USA.docx Mini-Supporting Statement IC Document
Mini - Supporting Statement - Feedback USA.docx Mini-Supporting Statement - Feedback USA IC Document
Mini - Supporting Statement - Feedback USA.docx Mini-Supporting Statement - Feedback USA IC Document
PTA, USCIS - USA Feedback, 20160413, PRIV Final.pdf Privacy Threshold Analysis IC Document

Information Collection (IC) Details

IC Title:	Feedback USA Button Pilot	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			September 2016 - Feedback on USA Button.docx		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29,500	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	29,500	29,500
Annual IC Time Burden (Hours)	590	590
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mini-Supporting Statement	Mini - Supporting Statement - Feedback USA.docx	10/05/2016
Mini-Supporting Statement - Feedback USA	Mini - Supporting Statement - Feedback USA.docx	10/05/2016
Mini-Supporting Statement - Feedback USA	Mini - Supporting Statement - Feedback USA.docx	10/05/2016
Privacy Threshold Analysis	PTA, USCIS - USA Feedback, 20160413, PRIV Final.pdf	10/05/2016

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