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Customer Satisfaction Survey
CISOMB Customer Satisfaction and Needs Assessment Survey
OMB: 1601-0021
IC ID: 218904
OMB.report
DHS/OS
OMB 1601-0021
ICR 201511-1601-001
IC 218904
( )
Documents and Forms
Document Name
Document Type
Form DHS-NEW
Customer Satisfaction Survey
Form and Instruction
DHS-NEW Customer Satisfaction Survey
Ombudsman Customer Satisfaction Survey DHS Form.pdf
www.dhs.gov/topic/cis-ombudsman
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Customer Satisfaction Survey
Agency IC Tracking Number:
Is this a Common Form?
No
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 and Instruction
DHS-NEW
Customer Satisfaction Survey
Ombudsman Customer Satisfaction Survey DHS Form.pdf
http://www.dhs.gov/topic/cis-ombudsman
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Homeland Security
Subfunction:
Border and Transportation Security
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
8,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
8,800
0
8,800
0
0
0
Annual IC Time Burden (Hours)
4,400
0
4,400
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.