MPHISE Assessment 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⚠️ Notice: This information collection may be referencing outdated material.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 1601-0014 can be found here:

Documents and Forms

Document Name Document Type
MPHISE_Survey_v7.docx Other-Mock Up - Survey Monkey
MPHISE Feedback Generic Clearance Submission .docx MPHISE Submission Form IC Document
DHSALL-002 Department of Homeland Security (DHS) Mailing and Other Lists System.log DHS/ALL-002 Department of Homeland Security (DHS) Mailing and Other Lists System IC Document
DHS Surveys, Interviews, and Focus Groups DHSALLPIA-069 .pdf DHS Surveys, Interviews, and Focus Groups DHSALLPIA-069 IC Document

Information Collection (IC) Details

IC Title:	MPHISE Assessment 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-Mock Up - Survey Monkey			MPHISE_Survey_v7.docx		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 195	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	195	195
Annual IC Time Burden (Hours)	39	39
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
MPHISE Submission Form	MPHISE Feedback Generic Clearance Submission .docx	06/12/2020
DHS/ALL-002 Department of Homeland Security (DHS) Mailing and Other Lists System	DHSALL-002 Department of Homeland Security (DHS) Mailing and Other Lists System.log	06/12/2020
DHS Surveys, Interviews, and Focus Groups DHSALLPIA-069	DHS Surveys, Interviews, and Focus Groups DHSALLPIA-069 .pdf	06/12/2020

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