Play/back 2016 Symposium 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⚠️ Notice: This information collection may be referencing outdated material.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 3136-0140 can be found here:

Documents and Forms

Document Name Document Type
Playback 2016 Symposium Survey.pdf www.surveymonkey.com/r/playbacksurvey Other-Customer Satisfaction Survey
Generic Clearance Submission NEH Playback 2016 Symposium Survey.docx Generic Clearance Submission NEH Playback 2016 Symposium Survey IC Document

Information Collection (IC) Details

IC Title:	Play/back 2016 Symposium 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
Other-Customer Satisfaction Survey			Playback 2016 Symposium Survey.pdf	https://www.surveymonkey.com/r/playbacksurvey	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Submission NEH Playback 2016 Symposium Survey	Generic Clearance Submission NEH Playback 2016 Symposium Survey.docx	10/27/2016

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