Road Maintenance Improvement Project

DOI Programmatic Clearance for Customer Satisfaction Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1040-0001 can be found here:

Documents and Forms

Document Name Document Type
Roads Maintenance Survey (OMB Control NO.1040-0001) final.pdf docs.google.com/forms/d/e/1FAIpQLSf7XwpyQUgfYuATISFCgoolp2Bi9VYqj1FBeGmin1xj1snsjA/viewform?usp=sf_link Other-Survey Tool
Survey Application, Great Plains 2-28-2018 (2) (2).docx Justification for a Survey IC Document

Information Collection (IC) Details

IC Title:	Road Maintenance Improvement Project	Agency IC Tracking Number:	FT - 69

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 Tool			Roads Maintenance Survey (OMB Control NO.1040-0001) final.pdf	https://docs.google.com/forms/d/e/1FAIpQLSf7XwpyQUgfYuATISFCgoolp2Bi9VYqj1FBeGmin1xj1snsjA/viewform?usp=sf_link	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 175	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for a Survey	Survey Application, Great Plains 2-28-2018 (2) (2).docx	03/22/2018

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