Customer Service Questionnaire

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0503-0021 can be found here:

Documents and Forms

Document Name Document Type
ICR External Customer Service Questionnaire.docx Other-Survey
Internal Compliance Survey - Generic Clearance Submission.docx Internal Compliance Survey - Gen IC Submission IC Document

Information Collection (IC) Details

IC Title:	Customer Service Questionnaire	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
Other-Survey			ICR External Customer Service Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,500	4,500
Annual IC Time Burden (Hours)	1,125	1,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Internal Compliance Survey - Gen IC Submission	Internal Compliance Survey - Generic Clearance Submission.docx	07/10/2019

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