Constituency Group Survey

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Constituency Group Survey Form and Instruction
1 Fast Track Instrument fast track instrument - constituency Groups_for OMB (002).docx Form and Instruction
Constituency Group Survey Fast Track OMB Application_for CB.doc Justification for Constituency Group Survey IC Document

Information Collection (IC) Details

IC Title:	Constituency Group Survey	Agency IC Tracking Number:

IC Status: Unchanged

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	1	Fast Track Instrument	fast track instrument - constituency Groups_for OMB (002).docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for Constituency Group Survey	Constituency Group Survey Fast Track OMB Application_for CB.doc	02/02/2016

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