Information Collection

SEA NA 2019 T4 PA Center Customer Survey

IC 236176 under ICR 201706-1800-001 · OMB 1800-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1800-0011 can be found here:

Documents and Forms

Document Name Document Type
SEA NA 2019 T4 PA Center Customer Survey Form
SEA NA 2019 T4 PA Center Customer Survey 1880-0011 survey for SEA NA 2019 T4PACenter 05202019.docx Form
1800-0011 cust survey Seldin.docx Generic Template IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SEA NA 2019 T4 PA Center Customer 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
Form	N/A	SEA NA 2019 T4 PA Center Customer Survey	1880-0011 survey for SEA NA 2019 T4PACenter 05202019.docx		Yes	Yes	Fillable Fileable

Line of Business: Education

Subfunction: Elementary, Secondary, and Vocational Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52	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	52	52
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Template	1800-0011 cust survey Seldin.docx	05/23/2019

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