OLIPA Survey Forms

Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3225-0002 can be found here:

Documents and Forms

Document Name Document Type
Form CSOSA - 2 OLIPA Survey Forms Form and Instruction
CSOSA - 2 Community Resource Day Program Presenter Feedback Survey community resource day presenter feedback - omb version 9-21-17.docx Form and Instruction
CSOSA - 5 Community Service Program Participant Feedback Survey OLIPA survey - community service participant feedback - omb version 9-21-17.docx Form and Instruction
CSOSA - 4 MPD Partnership Training Session Survey OLIPA survey - mpd partnership training - omb version 9-21-17.docx Form and Instruction
CSOSA - 1 Community Resource Day Program Participant Feedback Surv OLIPA survey- community resource day PARTICIPANT - omb version 9-21-17.docx Form and Instruction
CSOSA - 3 Community Justice Advisory Network (CJAN) Meeting Partic OLIPA survey- CJAN participant feed back - omb version 9-21-17.docx Form and Instruction
CSOSA - 6 Electronic CJAN Participant Feedback Form OLIPA CJAN ELECTRONIC snapshot document 9 -2017.pdf Form

Information Collection (IC) Details

IC Title:	OLIPA Survey Forms	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CSOSA - 2	Community Resource Day Program Presenter Feedback Survey	community resource day presenter feedback - omb version 9-21-17.docx	No		Paper Only
Form and Instruction	CSOSA - 5	Community Service Program Participant Feedback Survey	OLIPA survey - community service participant feedback - omb version 9-21-17.docx	No		Paper Only
Form and Instruction	CSOSA - 4	MPD Partnership Training Session Survey	OLIPA survey - mpd partnership training - omb version 9-21-17.docx	No		Paper Only
Form and Instruction	CSOSA - 1	Community Resource Day Program Participant Feedback Survey	OLIPA survey- community resource day PARTICIPANT - omb version 9-21-17.docx	No		Paper Only
Form and Instruction	CSOSA - 3	Community Justice Advisory Network (CJAN) Meeting Participant Form	OLIPA survey- CJAN participant feed back - omb version 9-21-17.docx	No		Paper Only
Form	CSOSA - 6	Electronic CJAN Participant Feedback Form	OLIPA CJAN ELECTRONIC snapshot document 9 -2017.pdf	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	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.