Information Collection Request

Quarterly Services Survey

ICR 201508-0607-004 · OMB 0607-0907 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form QSS-3A Quarterly Services Survey Form Modified Available
Att 6 - CognitiveTesting - FINANCE AND ACCOMMODATION.docx Supplementary Document Uploaded 2015-08-14 Available
Att 6 - Cognitive Testing - INITIAL.doc Supplementary Document Uploaded 2015-08-14 Available
Att 6 - Cognitive Testing - EXPANSION.doc Supplementary Document Uploaded 2015-08-14 Available
Att 5 - QSS Initial Letter.docx Supplementary Document Uploaded 2015-08-14 Available
Att 4 - Fax reminder.docx Supplementary Document Uploaded 2015-08-14 Available
Att 3 - Selected Screenshots from Online Instrument.pdf Supplementary Document Uploaded 2015-08-14 Available
Att 1 - Form matrix.xlsx Supplementary Document Uploaded 2015-08-14 Available
QSS 2015 OMB supporting statement Part B.docx Supporting Statement B Uploaded 2015-08-11 Available
QSS 2015 OMB supporting statement Part A with ESA revisions.docx Supporting Statement A Uploaded 2015-08-11 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
37228 Quarterly Services Survey Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2018 36 Months From Approved 09/30/2015
94,000 0 94,000
20,900 0 20,900
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 94,000 94,000 0 0 0 0
Annual Time Burden (Hours) 20,900 20,900 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No