Information Collection

American Community Survey Customer Feedback Form

IC 229408 under ICR 201705-0690-001 · OMB 0690-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form American Community Survey Customer Feedback Form	Form
Form ACS Feedback Form FeedbackFormScreenShot.pdf	Form
Survey ACS Data or User Survey DataOrSurveyUser_revised.pdf	Form
Generic Clearance for the Collection of Routine Customer Feedback Template-ACS 2017.docx Customer Feedback Fast Track Template	IC Document

IC Title:

American Community Survey Customer Feedback Form

Agency IC Tracking Number:

Census

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form	ACS Feedback Form	FeedbackFormScreenShot.pdf		Yes	Yes	Fillable Fileable
Form	Survey	ACS Data or User Survey	DataOrSurveyUser_revised.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Customer Feedback Fast Track Template	Generic Clearance for the Collection of Routine Customer Feedback Template-ACS 2017.docx	12/13/2017

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