ABA Complainant Customer Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3014-0011 can be found here:

Documents and Forms

Document Name Document Type
ABA Complainant Customer Satisfaction Survey Form
ABA Complainant Customer Satisfaction Survey ABA Customer Satisfaction Survey_Fillable PDF_Revised Final_5_17_18.pdf Form
ABA Online Customer Satisfaction Survey Instrument ABA Online Customer Satisfaction Survey Instrument_screenshots_May 2018.docx Form

Information Collection (IC) Details

IC Title:	ABA Complainant Customer Satisfaction Survey	Agency IC Tracking Number:	3014-011-01

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	ABA Complainant Customer Satisfaction Survey	ABA Customer Satisfaction Survey_Fillable PDF_Revised Final_5_17_18.pdf		Yes	No	Fillable Printable
Form	n/a	ABA Online Customer Satisfaction Survey Instrument	ABA Online Customer Satisfaction Survey Instrument_screenshots_May 2018.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 123	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	123	123
Annual IC Time Burden (Hours)	8	8
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.