NA-IM Student Feedback 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⚠️ Notice: This information collection may be referencing outdated material.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 1910-5160 can be found here:

Documents and Forms

Document Name Document Type
NA-IM Student Feedback Survey.dotx Other-Survey
Generic Clearance Submission Template_NA-IM Submission-Final.docx Generic Clearance Submission Template_NA-IM Submission-Final IC Document

Information Collection (IC) Details

IC Title:	NA-IM Student Feedback 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
Other-Survey			NA-IM Student Feedback Survey.dotx		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 933	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	933	933
Annual IC Time Burden (Hours)	78	78
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Submission Template_NA-IM Submission-Final	Generic Clearance Submission Template_NA-IM Submission-Final.docx	01/23/2020

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