E-Government Website Customer Satisfaction Surveys

Forms and Documents

Document	Type	Status	Availability
Form 045 2020 045 MyHealtheVet Mobile Nov 2020 (1)	Form and Instruction	New	Available
Form 046 Feedback 1090-0008 046 Feedback Survey Mapping Doc Forest Service Visitor Map survey	Form and Instruction	New	Repair queued
Form 047 2020 047 TDC Appeals Secure Messaging Survey vfinal2	Form and Instruction	New	Available
Form 048 2020 048 Q_FOIA - Desktop PX_Survey_20201112	Form and Instruction	New	Available
Form 044 2020 044 Survey Mapping Document CDC specific content pages Feedback survey	Form and Instruction	New	Repair queued
Form 043 2020 043 Survey Mapping Document DHA Tricare MTF survey	Form and Instruction	New	Repair queued
Form 041 2020 041 IRS Free File survey	Form and Instruction	New	Available
Form 041 2020 041 EITC Foresee survey questions 08182020	Form and Instruction	New	Repair queued
Form 040 2020 040 NOAA NGS Feedback Questions	Form and Instruction	New	Repair queued
Form 039 2020 039 SSA mySSA Web AccountManagement_09_24_20	Form and Instruction	New	Available
Form 038 2020 038 Crime Solutions Desktop Browse resubmit	Form and Instruction	New	Available
Form 030 2020 030 SSA Feedback Survey July 2020	Form and Instruction	New	Repair queued
Form 031 2020 031 SSA End of Task Survey July 2020	Form and Instruction	New	Available
Form 032 2020 032 TWE Pre-Results Survey v2	Form and Instruction	New	Repair queued
Form 034 2020 034 Q_DoDEA_Web_Browse_2020-05-21_DOT (1)	Form and Instruction	New	Available
Form 033 2020 033 OJP Crime Solutions Website Feedback Survey 20200731	Form and Instruction	New	Available
Form 037 2020 037 TDC for AUR Survey Questions- Final-9-2-2020 (003)	Form and Instruction	New	Repair queued
Form 036 2020 036 SEC Main Web Browse_20200714_DOT	Form and Instruction	New	Repair queued
Form 035 2020 035 SEC Main Mobile_20200714_DOT	Form and Instruction	New	Repair queued
Form 029 2020 029 DHS CRC v2 desktop Michelle mockup CRC Mobile Informational_Michelle mockup	Form and Instruction	New	Available
Form 028 2020 028 Feedback Survey Mapping Doc - CDC Advanced Search Feedback survey	Form and Instruction	New	Available
Form 027 2020 027 Q SSA mySSA Web AccountManagement_2020_6_4	Form and Instruction	New	Repair queued
Form 025 2020 025 1090-0008 Survey Mapping Document (VHA) IA 30820 A0_draft (1)	Form and Instruction	New	Available
Form 024 1090-0008 Feedback Survey - SBA	Form and Instruction	New	Available
Form 023 2020 023 Spanish Feedback Survey 06MAR2020 2020 023 COLA Outreach Survey 03MAR2020	Form and Instruction	New	Repair queued
Form 022 2020 022 TEOS Survey 2020-05-05 IRS	Form and Instruction	New	Available
Form 021 2020 021 Feedback Surveys OJP	Form and Instruction	New	Repair queued
Form 020 2020 021 Foresee_Q_SAMHSAStore_Web_Browse updated April 8 2020	Form and Instruction	New	Available
Form 020 2020 020 Q_DoDEA_Web_Browse Updated by Michelle April 3 2020	Form and Instruction	New	Available
Form 019 2020 019 Q_USCISv2_Web_Browse_20200221 Mobile_Browse_20200221	Form and Instruction	New	Available
Form 018 2020 018 Q_CDCMobile_Mobile_Browse_updated by Michelle March 30 2020	Form and Instruction	New	Available
Form 017 2020 017 ForeseeSurvey_COVID19	Form and Instruction	New	Available
Form 016 2020 016 SMART Mobile	Form and Instruction	New	Repair queued
Form 015 2020 015 SMART Desktop	Form and Instruction	New	Available
Form 014 2020 014 OJP Mobile	Form and Instruction	New	Available
Form 013 2020 013 OJP Desktop	Form and Instruction	New	Available
Form 012 2020 012 BJA Mobile	Form and Instruction	New	Repair queued
Form 011 2020 011 BJA Desktop	Form and Instruction	New	Available
Form 010 2020 010 OJJDP Email Newsletter	Form and Instruction	New	Repair queued
Form 009 2020 009 TWE Results Survey v3	Form and Instruction	New	Available
Form 008 2020 008 IRS Site Search Feedback Survey	Form and Instruction	New	Available
Form 007 2020 007 DOD SVCT Survey 2020_03_06	Form and Instruction	New	Repair queued
Form 006 2020 006 Q_OPMRetire_Web_Browse_20200225	Form and Instruction	New	Available
Form 005 2020 005 BJS Mobile Browse	Form and Instruction	New	Repair queued
Form 004 2020 004 SBA Mapping Document (Spanish Survey November 2019)	Form and Instruction	New	Available
Form 003 2020 003 IRS TDC Chat Survey (Spanish) (3)	Form and Instruction	New	Available
Form 002 2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17	Form and Instruction	New	Available
Form 001 2020 001 USPTO Patent, OCIO and OCFO Contact Centers V2	Form and Instruction	New	Available
Form 254 2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)	Form and Instruction	New	Available
Form 253 2019 253 USPTO Patent, OCIO and OCFO Contact Centers V2	Form and Instruction	New	Repair queued
Form 252 2019 252 NIJ mobile OJJDP desktop and Mobile	Form and Instruction	New	Available
Form 251 2019 251 Oceanservice.noaa.gov Desktop Informational 2019_12_20	Form and Instruction	New	Available
Form 250 2019 250 SSA Field Office Survey_12.19.19_Final	Form and Instruction	New	Available
Form 248 2019 249 IRS 2020 Beta Survey Draft v6	Form and Instruction	New	Available
Form 248 2019 248 Q SSA mySSA Web AccountManagement_2019_11_15	Form and Instruction	New	Repair queued
Form 247 2019 247 USITC 12-4-2019	Form and Instruction	New	Available
Form 246 2019 246 FTC.gov Consumer Mobile and Desktop	Form and Instruction	New	Repair queued
Form 245 2019 245 Copy of FTC Complaint Assistant Mobile 20191017	Form and Instruction	New	Repair queued
Form 244 2019 244 TWE Feedback Survey IRS	Form and Instruction	New	Available
Form 243 2019 243 FTC.gov Mobile 20191108	Form and Instruction	New	Available
Form 242 DeCA 242 Core Store Purchaser_08.28.19	Form and Instruction	New	Available
Form 241 2019 241 Fiscal Service Desktop Nov 1_2019	Form and Instruction	New	Available
Form 241 2019 241 FEMA RMD Risk MAP Meeting_rev_10.03.19 (1)	Form and Instruction	New	Repair queued
Form 240 2019 240 In-Page-Feedback.Tool.Qs-ForeSee NIDCR (1)	Form and Instruction	New	Available
Form 239 2019 239 FTC Feedback Survey_August 2019	Form and Instruction	New	Available
Form 238 2019 238 IRS Mobile Survey Model and Custom Questions v4 OMB	Form and Instruction	New	Available
Form 237 2019 237 Q_USCISv2_Web_Browse_20190815	Form and Instruction	New	Available
Form 236 2019 236 Q_NIJ_Web_Browse_2019 08 19.xlsx	Form and Instruction	New	Available
Form 235 2019 235 Security Administration	Form and Instruction	New	Repair queued
Form 234 2019 234 Q_SSA-mySSA_Web_AccountManagement_JULY 2019	Form and Instruction	New	Available
Form 233 2019 233 MHS Genesis Beneficiaries Feedback Survey	Form and Instruction	New	Available
Form 232 2019 232 FS FeedbackSurvey	Form and Instruction	New	Repair queued
Form 231 2019 231 NHLBI Website Feedback Survey	Form and Instruction	New	Available
Form 027 2019 027 NOS Website Feedback Survey 30736	Form and Instruction	New	Repair queued
Form 029 2019 029 Noridian Feedback Survey_Enrollment (2) 30628	Form and Instruction	New	Available
Form 028 2019 028 TRICARE Staff Feedback Survey	Form and Instruction	New	Repair queued
Form 025 2019 025 NIDCR FeedbackSurvey	Form and Instruction	New	Available
Form 024 2019 024 My HealtheVet Feedback Survey	Form and Instruction	New	Repair queued
Form 023 2019 023 FS FeedbackSurvey	Form and Instruction	New	Repair queued
Form 022 2019 022 IRS Withholding Calculator Feedback Survey	Form and Instruction	New	Available
Form Q_SAMHSAMain_Web_B Mapping and Questionnaire Documents IA 30839 A0 (SAMHSA)	Form and Instruction	New	Available
Form Q_PbgcCsat_Web_Bro Mapping and Questionnaire Documents IA 30829 A0 (DOJ)	Form and Instruction	New	Available
Form Q_ED.gov_Web_Brows Mapping and Questionnaire Documents IA 30833 A0 (ED)	Form and Instruction	New	Available
Form USITC v3_9.25.15_D Mapping and Questionnaire Documents IA 30830 A0 (ITC)	Form and Instruction	New	Repair queued
Form Q_NIJ_Web_Browse_2 Mapping and Questionnaire Documents IA 30828 (DOJ	Form and Instruction	New	Repair queued
Form Q_BEA_Web_Browse_2 Mapping and Questionnaire Documents IA 30826 A0 (BEA)	Form and Instruction	New	Repair queued
Form Q_NIDCR_Mobile_Bro Mapping and Questionnaire Documents IA 30825 A0 (NIH)	Form and Instruction	New	Available
Form Q_PbgcGov_Web_Brow Mapping and Questionnaire Documents IA 30827 A0 (PBGC)	Form and Instruction	New	Available
Form Q_NlmClinTr_Web_Br Mapping and Questionnaire Documents IA 30824 A0 (NLM)	Form and Instruction	New	Available
Form Q_VAMyHealtheVet_W Mapping and Questionnaire Documents IA 30820 A0 (VHA)	Form and Instruction	New	Available
Form Q_EPA_Web_Browse_2 Mapping and Questionnaire Documents IA 30818 A0 (EPA)	Form and Instruction	New	Available
Form CDC OMB Form 11.13 Mapping and Questionnaire Documents IA 30814 A0 (CDC)	Form and Instruction	New	Available
Form Q_NHLBI_Browse_201 Mapping and Questionnaire Documents IA 30813 A0 (NIH)	Form and Instruction	New	Available
Form AHRQ USPSTF Q'aire Mapping and Questionnaire Documents IA 30812 A0 (AHRQ)	Form and Instruction	New	Available
Form Q_FiscalService_We Mapping and Questionnaire Documents IA 30810 A0 (OFS)	Form and Instruction	New	Available
Form Q_ABMCv2_Web_Brows Mapping and Questionnaire Documents IA 30809 (ABMC)	Form and Instruction	New	Repair queued
Form Q_NIH-Main_Web_Bro Mapping and Questionnaire Documents IA 30807 A0 (NIH)	Form and Instruction	New	Available
Form Q_AIDSInfo_Mobile_ Mapping and Questionnaire Documents IA 30806 A0 (NLM)	Form and Instruction	New	Available
Form Q_DLA_Web_Browse_2 Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Form and Instruction	New	Available
Form Q_DLA_Web_Browse_2 Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Form and Instruction	New	Available
Form USDA NAL Browse 20 Mapping and Questionnaire Documents IA 30747 A1 (USDA)	Form and Instruction	New	Available
Form Q_TreasOfs_Web_Bro Mapping and Questionnaire Documents IA 30745 A1 (Dept of Treasury)	Form and Instruction	New	Available
Form NIH NCCIH Mobile I Mapping and Questionnaire Documents IA 30742 A1 (NIH)	Form and Instruction	New	Available
Form Q_OPMFHV_Web_Brows Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Form and Instruction	New	Available
Form Q_OPMFHV_Web_Brows Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Form and Instruction	New	Repair queued
Form 30739 Mapping and Questionnaire Documents IA 30739 A1 (FEMA)	Form and Instruction	New	Available
Form 30737 Mapping and Questionnaire Documents IA 30737 A1 (CIS)	Form and Instruction	New	Repair queued
Form 30736 Mapping and Questionnaire Documents IA 30736 A1 (NOAA)	Form and Instruction	New	Available
Form 30733 Mapping and Questionnaire Documents IA 30733 A1 (NOAA)	Form and Instruction	New	Repair queued
Form 30731 Mapping and Questionnaire Documents IA 30731 A1 (PBGC)	Form and Instruction	New	Available
Form 30723 Mapping and Questionnaire Documents IA 30723 A2 (NRC)	Form and Instruction	New	Repair queued
Form 30718 Mapping and Questionnaire Documents IA 30718 A2 (FAA)	Form and Instruction	New	Repair queued
Form 30715 Mapping and Questionnaire Documents IA 30715 A2 (VHA)	Form and Instruction	New	Repair queued
Form 30713 Mapping and Questionnaire Documents IA 30713 A2 (NIH)	Form and Instruction	New	Available
Form 020 2019 020 NHLBI FeedbackSurvey	Form and Instruction	New	Available
Form 019 2019 019 VA FeedbackSurvey	Form and Instruction	New	Available
Form 30710 Mapping and Questionnaire Documents IA 30710 A2 (FHA)	Form and Instruction	New	Repair queued
Form 30709 Mapping and Questionnaire Documents IA 30709 A2 (USDA)	Form and Instruction	New	Repair queued
Form 30705 Mapping and Questionnaire Documents IA 30705 A3 (FOH PSC)	Form and Instruction	New	Repair queued
Form 30695 Mapping and Questionnaire Documents IA 30695 A2 (VA)	Form and Instruction	New	Available
Form 30691 Mapping and Questionnaire Documents IA 30691 A3 (DOJ BJS)	Form and Instruction	New	Repair queued
Form 30689 Mapping and Questionnaire Documents IA 30689 A5 (IRS) start from here	Form and Instruction	New	Available
Form 020 Post-Launch Feedback Survey_Identify Theft Adaptive (2)	Form and Instruction	New	Repair queued
Form 30688 Mapping and Questionnaire Documents IA 30688 A4 (SSA)	Form and Instruction	New	Available
Form 30687 Mapping and Questionnaire Documents IA 30687 A3 (VA)	Form and Instruction	New	Available
Form 30683 Mapping and Questionnaire Documents IA 30683 A3 (OCPL)	Form and Instruction	New	Repair queued
Form 30682 A3 Mapping and Questionnaire Documents IA 30682 A3	Form and Instruction	New	Available
Form 30681 Mapping and Questionnaire Documents IA 30681 A4 (CIS)	Form and Instruction	New	Available
Form 30678 A3 Mapping and Questionnaire Documents IA 30678 A3 (NHTSA)	Form and Instruction	New	Available
Form 30676 A3 Mapping and Questionnaire Documents IA 30676 A3 (FS)	Form and Instruction	New	Available
Form 30674 Mapping and Questionnaire Documents IA 30674 A3 (OLMS)	Form and Instruction	New	Available
Form 30673 Mapping and Questionnaire Documents IA 30673 A3 (NASS)	Form and Instruction	New	Available
Form 30669 Mapping and Questionnaire Documents IA 30669 A3 (Dept of Treasury)	Form and Instruction	New	Available
Form 30667 Mapping and Questionnaire Documents IA 30667 A3 (EPA)	Form and Instruction	New	Repair queued
Form 30651 Mapping and Questionnaire Documents IA 30651 (DOD)	Form and Instruction	New	Available
Form 30660 Mapping and Questionnaire Documents IA 30660 A3 (OWH	Form and Instruction	New	Available
Form 30648 Mapping and Questionnaire Documents IA 30648 A5 (DS)	Form and Instruction	New	Available
Form 30636 Mapping and Questionnaire Documents IA 30636 A4 (BPA)	Form and Instruction	New	Available
Form 30635 Mapping and Questionnaire Documents IA 30635 A4 (OGMP)	Form and Instruction	New	Repair queued
Form 30634 Mapping and Questionnaire Documents IA 30634 A4 (BLS)	Form and Instruction	New	Available
Form 30633 M4 Mapping and Questionnaire Documents IA 30633 A4 (NSF)	Form and Instruction	New	Available
Form 30628 Mapping and Questionnaire Documents IA 30628 A4 (CMS)	Form and Instruction	New	Available
Form 30626 M5 Mapping and Questionnaire Documents IA 30626 A5 (NIH)Mapping and Questionnaire Documents IA 30626 A5 (NIH)	Form and Instruction	New	Available
Form 30624 M4 Mapping and Questionnaire Documents IA 30624 A4 (CIA)	Form and Instruction	New	Available
Form 30620 M4 Mapping and Questionnaire Documents IA 30620 A4 (RISC)	Form and Instruction	New	Available
Form 30614 M4 Mapping and Questionnaire Documents IA 30614 A4 (FSIS)	Form and Instruction	New	Available
Form 30600 M4 Mapping and Questionnaire Documents IA 30600 A4 (GAO)	Form and Instruction	New	Available
Form 20807 Mapping and Questionnaire Documents IA 20807 A0 (USM)	Form and Instruction	New	Available
Form 30610 M4 Mapping and Questionnaire Documents IA 30610 A4 (SI)	Form and Instruction	New	Available
Form 30606 A4 Mapping and Questionnaire Documents IA 30606 A4 (USPTO)	Form and Instruction	New	Available
Form 018 20190018 FEMA RMD Flood Economics Desktop_02.04.19	Form and Instruction	New	Available
Form 017 2019 017 NWS Weather.gov Desktop Informational	Form and Instruction	New	Available
Form 019 2019 019 NMFS-FeedbackSurvey-2018-12-20 (1)	Form and Instruction	New	Available
Form 018 2019 018 Oceanservice.noaa.gov Desktop Informational	Form and Instruction	New	Repair queued
Form 017 2019 017 SBA Sitewide Feedback Survey	Form and Instruction	New	Repair queued
Form 016 2019 016 NIH-NCCIH Desktop Browse Questionnaire_092517	Form and Instruction	New	Available
Form 009 2019 010 Post-Launch Feedback Survey Investor.gov_181002 - 2019 009 Post-Launch Feedback Survey Compound Interest Calculator _181002	Form and Instruction	New	Repair queued
Form 015 2019 015 NOAA.gov Desktop Informational	Form and Instruction	New	Available
Form 014 2019 014 SEC IAPD Mobile 2017 Questionnaire	Form and Instruction	New	Available
Form 012 2019 012 Q_IRS TDC Chat_20191116	Form and Instruction	New	Repair queued
Form 013 2019 013 TTB Feedback Survey	Form and Instruction	New	Available
Form 008 2019 008 TRICARE_Feedback Survey	Form and Instruction	New	Repair queued
Form 007 2019 007 NIDDK Feedback	Form and Instruction	New	Available
Form 006 2019 006 Post-Launch Feedback Survey _FTC Do Not Call Consumer Articles 10.19.18	Form and Instruction	New	Available
Form 005 2019 005 CRC Mobile Informational_2018.09.27	Form and Instruction	New	Available
Form 004 2019 004 Women%27s Health Desktop SP_10.16.18	Form and Instruction	New	Available
Form 003 2019 003 DLA_Loglines Magazine Readership Feedback Survey (1)	Form and Instruction	New	Available
Form 017 2018 017 Forest Service Functional (1)	Form and Instruction	New	Available
Form 016 2018 016 CMS - InsureKidsNow_20180810	Form and Instruction	New	Available
1090-0008 Survey Mapping Document.docx	Supplementary Document	Uploaded 2018-09-17	Repair queued
1090-0008 Generic Clearance Request Form 09132018.pdf	Supplementary Document	Uploaded 2018-09-13	Available
SS_Part_B_for_1090-0008_5.31.18.doc	Supporting Statement B	Uploaded 2018-05-31	Repair queued
SS_Part_A_1090-0008 5-31-18 Final.docx	Supporting Statement A	Uploaded 2018-05-31	Available
1090-0008 Published 30 Day Notice - 83 FR 25041.pdf	Supplementary Document	Uploaded 2018-05-31	Available
Published 60 Day Notice - 83 FR 9023.pdf	Supplementary Document	Uploaded 2018-05-21	Available
Foresee Gov Web Model Template.xlsx	Supplementary Document	Uploaded 2015-02-26	Available
The ForeSee CXA Methodology.pdf	Supplementary Document	Uploaded 2015-01-20	Available
Executive Order 12862.htm	Supplementary Document	Uploaded 2008-09-25	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
244778	2020 045 MyHealtheVet Mobile Nov 2020 (1)	Form and Instruction	New
244700	1090-0008 046 Feedback Survey Mapping Doc Forest Service Visitor Map survey	Form and Instruction	New
244569	2020 047 TDC Appeals Secure Messaging Survey vfinal2	Form and Instruction	New
244568	2020 048 Q_FOIA - Desktop PX_Survey_20201112	Form and Instruction	New
244522	2020 044 Survey Mapping Document CDC specific content pages Feedback survey	Form and Instruction	New
244431	2020 043 Survey Mapping Document DHA Tricare MTF survey	Form and Instruction	New
244394	2020 041 IRS Free File survey	Form and Instruction	New
244310	2020 041 EITC Foresee survey questions 08182020	Form and Instruction	New
243902	2020 040 NOAA NGS Feedback Questions	Form and Instruction	New
243831	2020 039 SSA mySSA Web AccountManagement_09_24_20	Form and Instruction	New
243819	2020 038 Crime Solutions Desktop Browse resubmit	Form and Instruction	New
243818	2020 030 SSA Feedback Survey July 2020	Form and Instruction	New
243791	2020 031 SSA End of Task Survey July 2020	Form and Instruction	New
243790	2020 032 TWE Pre-Results Survey v2	Form and Instruction	New
243788	2020 034 Q_DoDEA_Web_Browse_2020-05-21_DOT (1)	Form and Instruction	New
243787	2020 033 OJP Crime Solutions Website Feedback Survey 20200731	Form and Instruction	New
243764	2020 037 TDC for AUR Survey Questions- Final-9-2-2020 (003)	Form and Instruction	New
243763	2020 036 SEC Main Web Browse_20200714_DOT	Form and Instruction	New
243730	2020 035 SEC Main Mobile_20200714_DOT	Form and Instruction	New
242514	2020 029 DHS CRC v2 desktop Michelle mockup CRC Mobile Informational_Michelle mockup	Form and Instruction	New
242513	2020 028 Feedback Survey Mapping Doc - CDC Advanced Search Feedback survey	Form and Instruction	New
242226	2020 027 Q SSA mySSA Web AccountManagement_2020_6_4	Form and Instruction	New
241920	2020 025 1090-0008 Survey Mapping Document (VHA) IA 30820 A0_draft (1)	Form and Instruction	New
241744	1090-0008 Feedback Survey - SBA	Form and Instruction	New
241743	2020 023 Spanish Feedback Survey 06MAR2020 2020 023 COLA Outreach Survey 03MAR2020	Form and Instruction	New
241742	2020 022 TEOS Survey 2020-05-05 IRS	Form and Instruction	New
241741	2020 021 Feedback Surveys OJP	Form and Instruction	New
241361	2020 021 Foresee_Q_SAMHSAStore_Web_Browse updated April 8 2020	Form and Instruction	New
241360	2020 020 Q_DoDEA_Web_Browse Updated by Michelle April 3 2020	Form and Instruction	New
241359	2020 019 Q_USCISv2_Web_Browse_20200221 Mobile_Browse_20200221	Form and Instruction	New
241275	2020 018 Q_CDCMobile_Mobile_Browse_updated by Michelle March 30 2020	Form and Instruction	New
241272	2020 017 ForeseeSurvey_COVID19	Form and Instruction	New
241270	2020 016 SMART Mobile	Form and Instruction	New
241269	2020 015 SMART Desktop	Form and Instruction	New
241267	2020 014 OJP Mobile	Form and Instruction	New
241264	2020 013 OJP Desktop	Form and Instruction	New
241262	2020 012 BJA Mobile	Form and Instruction	New
241260	2020 011 BJA Desktop	Form and Instruction	New
241014	2020 010 OJJDP Email Newsletter	Form and Instruction	New
240974	2020 009 TWE Results Survey v3	Form and Instruction	New
240819	2020 008 IRS Site Search Feedback Survey	Form and Instruction	New
240647	2020 007 DOD SVCT Survey 2020_03_06	Form and Instruction	New
240276	2020 006 Q_OPMRetire_Web_Browse_20200225	Form and Instruction	New
240265	2020 005 BJS Mobile Browse	Form and Instruction	New
239615	2020 004 SBA Mapping Document (Spanish Survey November 2019)	Form and Instruction	New
239535	2020 003 IRS TDC Chat Survey (Spanish) (3)	Form and Instruction	New
239440	2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17	Form and Instruction	New
239315	2020 001 USPTO Patent, OCIO and OCFO Contact Centers V2	Form and Instruction	New
239313	2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)	Form and Instruction	New
239312	2019 253 USPTO Patent, OCIO and OCFO Contact Centers V2	Form and Instruction	New
239310	2019 252 NIJ mobile OJJDP desktop and Mobile	Form and Instruction	New
239101	2019 251 Oceanservice.noaa.gov Desktop Informational 2019_12_20	Form and Instruction	New
239064	2019 250 SSA Field Office Survey_12.19.19_Final	Form and Instruction	New
239063	2019 249 IRS 2020 Beta Survey Draft v6	Form and Instruction	New
238965	2019 248 Q SSA mySSA Web AccountManagement_2019_11_15	Form and Instruction	New
238964	2019 247 USITC 12-4-2019	Form and Instruction	New
238867	2019 246 FTC.gov Consumer Mobile and Desktop	Form and Instruction	New
238696	2019 245 Copy of FTC Complaint Assistant Mobile 20191017	Form and Instruction	New
238695	2019 244 TWE Feedback Survey IRS	Form and Instruction	New
238605	2019 243 FTC.gov Mobile 20191108	Form and Instruction	New
238449	DeCA 242 Core Store Purchaser_08.28.19	Form and Instruction	New
238448	2019 241 Fiscal Service Desktop Nov 1_2019	Form and Instruction	New
238390	2019 241 FEMA RMD Risk MAP Meeting_rev_10.03.19 (1)	Form and Instruction	New
238088	2019 240 In-Page-Feedback.Tool.Qs-ForeSee NIDCR (1)	Form and Instruction	New
237776	2019 239 FTC Feedback Survey_August 2019	Form and Instruction	New
237632	2019 238 IRS Mobile Survey Model and Custom Questions v4 OMB	Form and Instruction	New
237631	2019 237 Q_USCISv2_Web_Browse_20190815	Form and Instruction	New
237630	2019 236 Q_NIJ_Web_Browse_2019 08 19.xlsx	Form and Instruction	New
237523	2019 235 Security Administration	Form and Instruction	New
237217	2019 234 Q_SSA-mySSA_Web_AccountManagement_JULY 2019	Form and Instruction	New
237055	2019 233 MHS Genesis Beneficiaries Feedback Survey	Form and Instruction	New
236851	2019 232 FS FeedbackSurvey	Form and Instruction	New
236568	2019 231 NHLBI Website Feedback Survey	Form and Instruction	New
236151	2019 027 NOS Website Feedback Survey 30736	Form and Instruction	New
236150	2019 029 Noridian Feedback Survey_Enrollment (2) 30628	Form and Instruction	New
236031	2019 028 TRICARE Staff Feedback Survey	Form and Instruction	New
235688	2019 025 NIDCR FeedbackSurvey	Form and Instruction	New
235687	2019 024 My HealtheVet Feedback Survey	Form and Instruction	New
235686	2019 023 FS FeedbackSurvey	Form and Instruction	New
235685	2019 022 IRS Withholding Calculator Feedback Survey	Form and Instruction	New
235356	Mapping and Questionnaire Documents IA 30839 A0 (SAMHSA)	Form and Instruction	New
235355	Mapping and Questionnaire Documents IA 30829 A0 (DOJ)	Form and Instruction	New
235354	Mapping and Questionnaire Documents IA 30833 A0 (ED)	Form and Instruction	New
235353	Mapping and Questionnaire Documents IA 30830 A0 (ITC)	Form and Instruction	New
235351	Mapping and Questionnaire Documents IA 30828 (DOJ	Form and Instruction	New
235349	Mapping and Questionnaire Documents IA 30826 A0 (BEA)	Form and Instruction	New
235348	Mapping and Questionnaire Documents IA 30825 A0 (NIH)	Form and Instruction	New
235347	Mapping and Questionnaire Documents IA 30827 A0 (PBGC)	Form and Instruction	New
235346	Mapping and Questionnaire Documents IA 30824 A0 (NLM)	Form and Instruction	New
235345	Mapping and Questionnaire Documents IA 30820 A0 (VHA)	Form and Instruction	New
235344	Mapping and Questionnaire Documents IA 30818 A0 (EPA)	Form and Instruction	New
235343	Mapping and Questionnaire Documents IA 30814 A0 (CDC)	Form and Instruction	New
235342	Mapping and Questionnaire Documents IA 30813 A0 (NIH)	Form and Instruction	New
235341	Mapping and Questionnaire Documents IA 30812 A0 (AHRQ)	Form and Instruction	New
235340	Mapping and Questionnaire Documents IA 30810 A0 (OFS)	Form and Instruction	New
235339	Mapping and Questionnaire Documents IA 30809 (ABMC)	Form and Instruction	New
235338	Mapping and Questionnaire Documents IA 30807 A0 (NIH)	Form and Instruction	New
235337	Mapping and Questionnaire Documents IA 30806 A0 (NLM)	Form and Instruction	New
235335	Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Form and Instruction	New
235317	Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Form and Instruction	New
235316	Mapping and Questionnaire Documents IA 30747 A1 (USDA)	Form and Instruction	New
235315	Mapping and Questionnaire Documents IA 30745 A1 (Dept of Treasury)	Form and Instruction	New
235312	Mapping and Questionnaire Documents IA 30742 A1 (NIH)	Form and Instruction	New
235310	Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Form and Instruction	New
235212	Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Form and Instruction	New
235211	Mapping and Questionnaire Documents IA 30739 A1 (FEMA)	Form and Instruction	New
235210	Mapping and Questionnaire Documents IA 30737 A1 (CIS)	Form and Instruction	New
235207	Mapping and Questionnaire Documents IA 30736 A1 (NOAA)	Form and Instruction	New
235206	Mapping and Questionnaire Documents IA 30733 A1 (NOAA)	Form and Instruction	New
235205	Mapping and Questionnaire Documents IA 30731 A1 (PBGC)	Form and Instruction	New
235204	Mapping and Questionnaire Documents IA 30723 A2 (NRC)	Form and Instruction	New
235202	Mapping and Questionnaire Documents IA 30718 A2 (FAA)	Form and Instruction	New
235201	Mapping and Questionnaire Documents IA 30715 A2 (VHA)	Form and Instruction	New
235200	Mapping and Questionnaire Documents IA 30713 A2 (NIH)	Form and Instruction	New
235199	2019 020 NHLBI FeedbackSurvey	Form and Instruction	New
235198	2019 019 VA FeedbackSurvey	Form and Instruction	New
235159	Mapping and Questionnaire Documents IA 30710 A2 (FHA)	Form and Instruction	New
235158	Mapping and Questionnaire Documents IA 30709 A2 (USDA)	Form and Instruction	New
235157	Mapping and Questionnaire Documents IA 30705 A3 (FOH PSC)	Form and Instruction	New
235156	Mapping and Questionnaire Documents IA 30695 A2 (VA)	Form and Instruction	New
235155	Mapping and Questionnaire Documents IA 30691 A3 (DOJ BJS)	Form and Instruction	New
235154	Mapping and Questionnaire Documents IA 30689 A5 (IRS) start from here	Form and Instruction	New
235121	Post-Launch Feedback Survey_Identify Theft Adaptive (2)	Form and Instruction	New
235037	Mapping and Questionnaire Documents IA 30688 A4 (SSA)	Form and Instruction	New
235036	Mapping and Questionnaire Documents IA 30687 A3 (VA)	Form and Instruction	New
235035	Mapping and Questionnaire Documents IA 30683 A3 (OCPL)	Form and Instruction	New
235034	Mapping and Questionnaire Documents IA 30682 A3	Form and Instruction	New
235032	Mapping and Questionnaire Documents IA 30681 A4 (CIS)	Form and Instruction	New
235031	Mapping and Questionnaire Documents IA 30678 A3 (NHTSA)	Form and Instruction	New
235030	Mapping and Questionnaire Documents IA 30676 A3 (FS)	Form and Instruction	New
235029	Mapping and Questionnaire Documents IA 30674 A3 (OLMS)	Form and Instruction	New
235028	Mapping and Questionnaire Documents IA 30673 A3 (NASS)	Form and Instruction	New
235027	Mapping and Questionnaire Documents IA 30669 A3 (Dept of Treasury)	Form and Instruction	New
235025	Mapping and Questionnaire Documents IA 30667 A3 (EPA)	Form and Instruction	New
235023	Mapping and Questionnaire Documents IA 30651 (DOD)	Form and Instruction	New
235019	Mapping and Questionnaire Documents IA 30660 A3 (OWH	Form and Instruction	New
235017	Mapping and Questionnaire Documents IA 30648 A5 (DS)	Form and Instruction	New
235016	Mapping and Questionnaire Documents IA 30636 A4 (BPA)	Form and Instruction	New
235015	Mapping and Questionnaire Documents IA 30635 A4 (OGMP)	Form and Instruction	New
235014	Mapping and Questionnaire Documents IA 30634 A4 (BLS)	Form and Instruction	New
234987	Mapping and Questionnaire Documents IA 30633 A4 (NSF)	Form and Instruction	New
234986	Mapping and Questionnaire Documents IA 30628 A4 (CMS)	Form and Instruction	New
234985	Mapping and Questionnaire Documents IA 30626 A5 (NIH)Mapping and Questionnaire Documents IA 30626 A5 (NIH)	Form and Instruction	New
234984	Mapping and Questionnaire Documents IA 30624 A4 (CIA)	Form and Instruction	New
234983	Mapping and Questionnaire Documents IA 30620 A4 (RISC)	Form and Instruction	New
234982	Mapping and Questionnaire Documents IA 30614 A4 (FSIS)	Form and Instruction	New
234981	Mapping and Questionnaire Documents IA 30600 A4 (GAO)	Form and Instruction	New
234980	Mapping and Questionnaire Documents IA 20807 A0 (USM)	Form and Instruction	New
234979	Mapping and Questionnaire Documents IA 30610 A4 (SI)	Form and Instruction	New
234977	Mapping and Questionnaire Documents IA 30606 A4 (USPTO)	Form and Instruction	New
234976	20190018 FEMA RMD Flood Economics Desktop_02.04.19	Form and Instruction	New
234862	2019 017 NWS Weather.gov Desktop Informational	Form and Instruction	New
234672	2019 019 NMFS-FeedbackSurvey-2018-12-20 (1)	Form and Instruction	New
234671	2019 018 Oceanservice.noaa.gov Desktop Informational	Form and Instruction	New
234664	2019 017 SBA Sitewide Feedback Survey	Form and Instruction	New
234647	2019 016 NIH-NCCIH Desktop Browse Questionnaire_092517	Form and Instruction	New
234429	2019 010 Post-Launch Feedback Survey Investor.gov_181002 - 2019 009 Post-Launch Feedback Survey Compound Interest Calculator _181002	Form and Instruction	New
234195	2019 015 NOAA.gov Desktop Informational	Form and Instruction	New
234176	2019 014 SEC IAPD Mobile 2017 Questionnaire	Form and Instruction	New
234173	2019 012 Q_IRS TDC Chat_20191116	Form and Instruction	New
234172	2019 013 TTB Feedback Survey	Form and Instruction	New
233990	2019 008 TRICARE_Feedback Survey	Form and Instruction	New
233984	2019 007 NIDDK Feedback	Form and Instruction	New
233981	2019 006 Post-Launch Feedback Survey _FTC Do Not Call Consumer Articles 10.19.18	Form and Instruction	New
233790	2019 005 CRC Mobile Informational_2018.09.27	Form and Instruction	New
233721	2019 004 Women%27s Health Desktop SP_10.16.18	Form and Instruction	New
233719	2019 003 DLA_Loglines Magazine Readership Feedback Survey (1)	Form and Instruction	New
233187	2018 017 Forest Service Functional (1)	Form and Instruction	New
233184	2018 016 CMS - InsureKidsNow_20180810	Form and Instruction	New

ICR Details

OMB Control No: 1090-0008	ICR Reference No: 201805-1090-003
Status: Active	Previous ICR Reference No: 201412-1090-002
Agency/Subagency: DOI/ASPMB	Agency Tracking No: 1090-0008
Title: E-Government Website Customer Satisfaction Surveys
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/17/2018
	Date Received in OIRA: 07/27/2018
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), complete the Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) the agency must complete the Survey Mapping Template to allow for a cross comparison of survey questions with the survey question bank.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved	09/30/2018
Responses	1,250,000	0	3,750,000
Time Burden (Hours)	52,083	0	156,250
Cost Burden (Dollars)	0	0	0

---

Abstract: This is a request for a three-year extension of the generic clearance to conduct customer satisfaction surveys for federal government websites. This was formerly known as the American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Survey. The contractor that has provided the service for over a decade, ForeSee, is now using a derivative of the ACSI methodology called Customer Experience Analytics or CXA. This extension will allow for continued use of a data-driven and statistically valid approach to understanding customer satisfaction with agency websites, which are playing a strategic role of ever-increasing importance. The ultimate objective is to help agencies become more citizen-centric and achieve higher levels of citizen trust and confidence.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 9023	03/02/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 25041	05/31/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 169

IC Title	Form No.	Form Name
2019 250 SSA Field Office Survey_12.19.19_Final	250	2019 250 SSA Field Office Survey_12.19.19_Final.xlsx
2020 008 IRS Site Search Feedback Survey	008	2020 008 IRS Site Search Feedback Survey Mar 11 20
2019 020 NHLBI FeedbackSurvey	020	2019 020 NHLBI FeedbackSurvey
Mapping and Questionnaire Documents IA 30624 A4 (CIA)	30624 M4, 30624 M4	Q_CIA Careers _Mobile_Browse_20181109_DOT (2) ,   Q_CIA Careers_Website_Browse_ 20180719_DOT (4)
2019 007 NIDDK Feedback	007	2019 007 NIDDK Feedback
Mapping and Questionnaire Documents IA 30606 A4 (USPTO)	30606 A4, 30603 M4, 30603 M4	Q_USPTO_Email_ServiceCenter_Applicant_20170823_DOT ,   Q_USPTO_Email_ServiceCenter_Examiner_20170823_DOT ,   USPTO_ContactCenter_ServiceCenter_PATENTS_11_28_18
Mapping and Questionnaire Documents IA 30648 A5 (DS)	30648	Q_DOSCareers_Web_Browse_20170808
Mapping and Questionnaire Documents IA 30651 (DOD)	30651	Q_DoDEA_Web_Browse_20180212_DOT
Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Q_OPMFHV_Web_Browse_20181026_DOT, Q_OPMUSAJOBS_Web_Browse_20170405, Q_OPMUSAJOBS_Web_Browse_Completer_20130528, Q_OPMUSAJOBS_Web_Browse_PostCompleter_20150728, Q_OPMRetire_Web_Browse_20190107_DOT, Q_OPMUSAJOBS_Mobile_Browse_20170321, Q_OPMUSAJOBS_Web_Browse_Abandoner_20130528	Q_OPMFHV_Web_Browse_20181026_DOT ,   Q_OPMRetire_Web_Browse_20190107_DOT ,   Q_OPMUSAJOBS_Mobile_Browse_20170321 ,   Q_OPMUSAJOBS_Web_Browse_20170405 ,   Q_OPMUSAJOBS_Web_Browse_Abandoner_20130528 ,   Q_OPMUSAJOBS_Web_Browse_Completer_20130528 ,   Q_OPMUSAJOBS_Web_Browse_PostCompleter_20150728
Mapping and Questionnaire Documents IA 30820 A0 (VHA)	Q_VAMyHealtheVet_Web_Browse_20180326_DOT	Q_VAMyHealtheVet_Web_Browse_20180326_DOT
2019 024 My HealtheVet Feedback Survey	024	2019 024 My HealtheVet Feedback Survey
2019 023 FS FeedbackSurvey	023	2019 023 FS FeedbackSurvey
2019 028 TRICARE Staff Feedback Survey	028	2019 028 TRICARE Staff Feedback Survey
2019 232 FS FeedbackSurvey	232	2019 232 FS FeedbackSurvey
2020 030 SSA Feedback Survey July 2020	030	2020 030 SSA Feedback Survey July 2020
2020 012 BJA Mobile	012	2020 012 BJA Mobile
2020 016 SMART Mobile	016	2020 016 SMART Mobile
2020 018 Q_CDCMobile_Mobile_Browse_updated by Michelle March 30 2020	018, 018	2020 018 Q_CDCMobile_Mobile_Browse_updated by Michelle March 30 2020 ,   2020 018 Q_CDCEnter_Web_Browse_updated by Michelle March 30 2020
2019 245 Copy of FTC Complaint Assistant Mobile 20191017	245	2019 245 Copy of FTC Complaint Assistant Mobile 20191017
Mapping and Questionnaire Documents IA 30825 A0 (NIH)	Q_NIDCR_Web_Browse_20180719_DOT, Q_NIDCR_Mobile_Browse_ 20180719_DOT	Q_NIDCR_Mobile_Browse_ 20180719_DOT ,   Q_NIDCR_Web_Browse_20180719_DOT
2020 028 Feedback Survey Mapping Doc - CDC Advanced Search Feedback survey	028	2020 028 Feedback Survey Mapping Doc - CDC Advanced Search Feedback survey
2019 017 NWS Weather.gov Desktop Informational	017	2019 017 NWS Weather.gov Desktop Informational
Mapping and Questionnaire Documents IA 30828 (DOJ	Q_NIJ_Web_Browse_20170807_DOT	Q_NIJ_Web_Browse_20170807_DOT
Mapping and Questionnaire Documents IA 30826 A0 (BEA)	Q_BEA_Web_Browse_20170111	Q_BEA_Web_Browse_20170111
2019 005 CRC Mobile Informational_2018.09.27	005	2019 005 CRC Mobile Informational_2018.09.27
2019 016 NIH-NCCIH Desktop Browse Questionnaire_092517	016	2019 016 NIH-NCCIH Desktop Browse Questionnaire_092517
2019 008 TRICARE_Feedback Survey	008	2019 008 TRICARE_Feedback Survey
2019 015 NOAA.gov Desktop Informational	015	2019 015 NOAA.gov Desktop Informational
Mapping and Questionnaire Documents IA 30718 A2 (FAA)	30718	FAA Questionnaire updates 3.30.16_DOT
Mapping and Questionnaire Documents IA 30635 A4 (OGMP)	30635	Q_Grants.gov_Web_Browse_20170512
Mapping and Questionnaire Documents IA 30745 A1 (Dept of Treasury)	Q_TreasOfs_Web_Browse_20150330	Q_TreasOfs_Web_Browse_20150330
1090-0008 046 Feedback Survey Mapping Doc Forest Service Visitor Map survey	046 Feedback	1090-0008 046 Feedback Survey Mapping Doc Forest Service Visitor Map survey
2019 238 IRS Mobile Survey Model and Custom Questions v4 OMB	238	2019 238 IRS Mobile Survey Model and Custom Questions v4 OMB
2020 006 Q_OPMRetire_Web_Browse_20200225	006	2020 006 Q_OPMRetire_Web_Browse_20200225
2019 241 Fiscal Service Desktop Nov 1_2019	241	2019 241 Fiscal Service Desktop Nov 1_2019
DeCA 242 Core Store Purchaser_08.28.19	242	DeCA Core Store Purchaser_08.28.19
2019 246 FTC.gov Consumer Mobile and Desktop	246, 246	2019 246 FTC.gov Consumer Mobile ,   2019 246 FTC.gov Consumer Desktop
2020 013 OJP Desktop	013	2020 013 OJP Desktop
2020 041 EITC Foresee survey questions 08182020	041	2020 041 EITC Foresee survey questions 08182020
Mapping and Questionnaire Documents IA 30688 A4 (SSA)	30688, 30688, 30688, 30688, 30688, 30688, 30688, 30688, 30688, 30688, 30688	Q_SSABSO_Web_AccountManagement_201805014_DOT ,   Q_SSADiagnostic_Web_Browse_20160718 ,   Q_SSADisability_Web_AccountManagement_20181001_DOT ,   Q_SSAExtraHelp_Web_AccountManagement_20180517_DOT ,   Q_SSAiAppeals_Web_AccountManagement_20180803_DOT ,   Q_SSAiClaim_Web_AccountManagement_20160614_DOT ,   Q_SSAMain_Web_Browse_20180705_DOT ,   Q_SSAMobileWage_Mobile_AccountManagement_20180803_DOT ,   Q_SSA-mySSA_Web_AccountManagement_11_20_18_DOT ,   Q_SSARetirementEstimator_Web_AccountManagement_20160614 ,   SSA Mobile Innovation Questionnaire Update 10.16.14_DOT (1)
Mapping and Questionnaire Documents IA 30705 A3 (FOH PSC)	30705, 30705, 30705, 30705	CSAT PSC 20181207_DOT ,   Q_PSC_Web_Browse_20180419_DOT ,   Q_PSCMilestone_Web_Browse_New Feedback Survey_20180430 ,   Q_PSCNewSecuirutyFeedbackSurvey_Web_Browse_20180709_DOT
2019 248 Q SSA mySSA Web AccountManagement_2019_11_15	248	2019 248 Q SSA mySSA Web AccountManagement_2019_11_15
2019 003 DLA_Loglines Magazine Readership Feedback Survey (1)	003	2019 003 DLA_Loglines Magazine Readership Feedback Survey (1)
2019 004 Women%27s Health Desktop SP_10.16.18	004	2019 004 Women%27s Health Desktop SP_10.16.18
2018 016 CMS - InsureKidsNow_20180810	016	2018 016 CMS - InsureKidsNow_20180810
2018 017 Forest Service Functional (1)	017	2018 017 Forest Service Functional (1)
Mapping and Questionnaire Documents IA 30610 A4 (SI)	30610 M4, 30610 M4	Q_Smithsonian Mobile_Browse_20180514_DOT ,   Q_Smithsonian_Web_Browse_20180514_DOT
2019 006 Post-Launch Feedback Survey _FTC Do Not Call Consumer Articles 10.19.18	006	2019 006 Post-Launch Feedback Survey _FTC Do Not Call Consumer Articles 10.19.18
20190018 FEMA RMD Flood Economics Desktop_02.04.19	018	20190018 FEMA RMD Flood Economics Desktop_02.04.19
Mapping and Questionnaire Documents IA 30620 A4 (RISC)	30620 M4	RegInfo v3 CQ Changes 05-04-2017_DOT
Mapping and Questionnaire Documents IA 30676 A3 (FS)	30676 A3	Q_TreasOfs_Web_Browse_20150330 (2)
Mapping and Questionnaire Documents IA 30674 A3 (OLMS)	30674	Q_DOLUnion_Web_Browse_20120924
Mapping and Questionnaire Documents IA 30682 A3	30682 A3	DoD Enterprise Questionnaire 6-1-17
Mapping and Questionnaire Documents IA 30687 A3 (VA)	30687	Q_VBA_Web_Browse_20160107_DOT
Mapping and Questionnaire Documents IA 30742 A1 (NIH)	NIH-NCCIH Desktop Browse Questionnaire_092517, NIH NCCIH Mobile Informationa 09282018_DOT	NIH NCCIH Mobile Informationa 09282018_DOT ,   NIH-NCCIH Desktop Browse Questionnaire_092517
Mapping and Questionnaire Documents IA 30818 A0 (EPA)	Q_EPA_Web_Browse_20181108_DOT	Q_EPA_Web_Browse_20181108_DOT
Mapping and Questionnaire Documents IA 30810 A0 (OFS)	Q_FiscalService_Web_Browse_20180130_DOT (1), Q_TreasuryDirect_Browse_20171117_DOT (6)	Q_FiscalService_Web_Browse_20180130_DOT (1) ,   Q_TreasuryDirect_Browse_20171117_DOT (6)
2019 025 NIDCR FeedbackSurvey	025	2019 025 NIDCR FeedbackSurvey
2019 243 FTC.gov Mobile 20191108	243	2019 243 FTC.gov Mobile 20191108
2020 001 USPTO Patent, OCIO and OCFO Contact Centers V2	001	2020 001 USPTO Patent, OCIO and OCFO Contact Centers V2
2020 021 Foresee_Q_SAMHSAStore_Web_Browse updated April 8 2020	020	2020 021 Foresee_Q_SAMHSAStore_Web_Browse updated April 8 2020
2020 019 Q_USCISv2_Web_Browse_20200221 Mobile_Browse_20200221	019 , 019	2020 019 Q_USCISMobile_Mobile_Browse_20200221 ,   2020 019 Q_USCISv2_Web_Browse_20200221
2020 037 TDC for AUR Survey Questions- Final-9-2-2020 (003)	037	2020 037 TDC for AUR Survey Questions- Final-9-2-2020 (003)
2020 007 DOD SVCT Survey 2020_03_06	007	2020 007 DOD SVCT Survey 2020_03_06
Mapping and Questionnaire Documents IA 30689 A5 (IRS) start from here	30689, 30689, 30689, 30689, 30689, 30689, 30689	IRSv3_Web_Browse_20181107 ,   Q_IRS TDC Chat_20181217_DOT (1) ,   Q_IRS TDC Chat_20181217_DOT ,   Q_IRSACH_Web_Browse_20150814 ,   Q_IRSMobileSP_Mobile_Browse_20161004 ,   Q_IRSOnlineAccount_Web_Browse_V320190109_DOT ,   Q_IRSSpanishv2_Web_Browse_20160701
Mapping and Questionnaire Documents IA 30691 A3 (DOJ BJS)	30691	Q_BJS_Web_Browse_20180130_DOT
Mapping and Questionnaire Documents IA 30710 A2 (FHA)	30710	Q_FHWA_Web_Browse_20130904
2019 249 IRS 2020 Beta Survey Draft v6	248	2019 249 IRS 2020 Beta Survey Draft v6
2020 040 NOAA NGS Feedback Questions	040	2020 040 NOAA NGS Feedback Questions
Mapping and Questionnaire Documents IA 30713 A2 (NIH)	30713	Q_NICHD_Web_Browse_20181106_DOT
Mapping and Questionnaire Documents IA 30715 A2 (VHA)	30715	VHA_Medical_Centers_Questionnaire Redesign Questions 12-14-2017_DOT
Mapping and Questionnaire Documents IA 30626 A5 (NIH)Mapping and Questionnaire Documents IA 30626 A5 (NIH)	30626 M5, 30626 M5	Q_NIDDK_Mobile_Browse_20180820_DOT ,   Q_NIDDK_Web_Browse_20180820_DOT
Mapping and Questionnaire Documents IA 30628 A4 (CMS)	30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628, 30628	Q_CGSDMEB_Web_Browse_20180907_DOT ,   Q_CGSDMEC_Web_Browse_20180907_DOT ,   Q_CGSJ15_Web_Browse_20180907_DOT ,   Q_CMS-FCSO_Web_Browse_20170214 ,   Q_NGSJ6_Web_Browse_20180618_DOT ,   Q_NGSJK_Web_Browse_20180618_DOT ,   Q_NordDmeJa_Web_Browse_20161227 ,   Q_NordJE_Web_Browse_20180418_DOT ,   Q_NordJf_Web_Browse_20161227 ,   Q_Novitas-JH_Web_Browse_20170221_DOT ,   Q_Novitas-JL_Web_Browse_20180124_DOT ,   Q_PalmettoGBA_JJ_Web_Browse_20180108_DOT ,   Q_PalmettoGBA_Web_Browse_20170329 ,   Q_WPSJ5_Web_Browse_20180202_DOT ,   Q_WPSJ5_Web_Browse_20180202_DOT
2019 010 Post-Launch Feedback Survey Investor.gov_181002 - 2019 009 Post-Launch Feedback Survey Compound Interest Calculator _181002	010, 009	2019 009 Post-Launch Feedback Survey Compound Interest Calculator _181002 ,   2019 010 Post-Launch Feedback Survey Investor.gov_181002
Mapping and Questionnaire Documents IA 30636 A4 (BPA)	30636	Q_DOSMain_Web_Browse_20170619_DOT
Post-Launch Feedback Survey_Identify Theft Adaptive (2)	020	Post-Launch Feedback Survey_Identify Theft Adaptive (2)
Mapping and Questionnaire Documents IA 30667 A3 (EPA)	30667	Mapping and Questionnaire Documents IA 30667 A3 (EPA)
Mapping and Questionnaire Documents IA 30678 A3 (NHTSA)	30678 A3, 30678	Q_NHTSAmain_Web_Browse_20172112_DOT (1) ,   Q_NHTSASaferCar_Web_Browse_20170406 (1)
Mapping and Questionnaire Documents IA 30824 A0 (NLM)	Q_NlmClinTr_Web_Browse_20160920 (2)	Q_NlmClinTr_Web_Browse_20160920 (2)
2019 239 FTC Feedback Survey_August 2019	239	2019 239 FTC Feedback Survey_August 2019
2019 251 Oceanservice.noaa.gov Desktop Informational 2019_12_20	251	2019 251 Oceanservice.noaa.gov Desktop Informational 2019_12_20
2020 044 Survey Mapping Document CDC specific content pages Feedback survey	044	2020 044 Survey Mapping Document CDC specific content pages Feedback survey
2020 031 SSA End of Task Survey July 2020	031	2020 031 SSA End of Task Survey July 2020
2020 015 SMART Desktop	015	2020 015 SMART Desktop
1090-0008 Feedback Survey - SBA	024	1090-0008 Feedback Survey - SBA
2020 027 Q SSA mySSA Web AccountManagement_2020_6_4	027	2020 027 Q SSA mySSA Web AccountManagement_2020_6_4
2019 231 NHLBI Website Feedback Survey	231	2019 231 NHLBI Website Feedback Survey
Mapping and Questionnaire Documents IA 30695 A2 (VA)	30695, 30695	Q_VA_Web_Browse_20181107_DOT ,   Q_VAVantageP_Web_Browse_20170329
2019 247 USITC 12-4-2019	247	2019 247 USITC 12-4-2019
2019 237 Q_USCISv2_Web_Browse_20190815	237	2019 237 Q_USCISv2_Web_Browse_20190815
2019 017 SBA Sitewide Feedback Survey	017	2019 017 SBA Sitewide Feedback Survey
Mapping and Questionnaire Documents IA 20807 A0 (USM)	20807, 20807	Q_USMint_Mobile_Browse_20180718_DOT ,   Q_USMint_Web_Browse_20180719_DOT
Mapping and Questionnaire Documents IA 30600 A4 (GAO)	30600 M4, 30660 M4	Q_GAO_Mobile_Browse_20161013 ,   Q_GAO_Web_Browse_2018.7.05_DOT
Mapping and Questionnaire Documents IA 30731 A1 (PBGC)	30731	Q_PbgcCsat_Web_Browse_2018040610_DOT
Mapping and Questionnaire Documents IA 30634 A4 (BLS)	30634	Q_BLS_Web_Browse_20170130
Mapping and Questionnaire Documents IA 30827 A0 (PBGC)	Q_NIDCR_Web_Browse_20180719_DOT, Q_PbgcGov_Web_Browse_20180410_DOT	Q_PbgcGov_Web_Browse_20180410_DOT ,   Q_NIDCR_Web_Browse_20180719_DOT
Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Q_DLA_Web_Browse_20171129	Q_DLA_Web_Browse_20171129
Mapping and Questionnaire Documents IA 30741 A1 (OPM)	Q_OPMFHV_Web_Browse_20181026_DOT, Q_OPMRetire_Web_Browse_20190107_DOT, Q_OPMUSAJOBS_Web_Browse_20170405, Q_USAStaffing_Web_JobRecruiter_OnboardingManager_2, Q_OPMUSAJOBS_Mobile_Browse_20170321, Q_OPMUSAJOBS_Web_Browse_Completer_20130528, Q_OPMUSAJOBS_Web_Browse_PostCompleter_20150728, Q_USAStaffing_Web_JobSeeker_ApplicationManager_201, Q_OPMUSAJOBS_Web_Browse_Abandoner_20130528, Q_OPMUSAJOBS_Web_Manager_20190129_DOT	Q_OPMFHV_Web_Browse_20181026_DOT ,   Q_OPMRetire_Web_Browse_20190107_DOT ,   Q_OPMUSAJOBS_Mobile_Browse_20170321 ,   Q_OPMUSAJOBS_Web_Browse_20170405 ,   Q_OPMUSAJOBS_Web_Browse_Abandoner_20130528 ,   Q_OPMUSAJOBS_Web_Browse_Completer_20130528 ,   Q_OPMUSAJOBS_Web_Browse_PostCompleter_20150728 ,   Q_OPMUSAJOBS_Web_Manager_20190129_DOT ,   Q_USAStaffing_Web_JobRecruiter_OnboardingManager_20140708 ,   Q_USAStaffing_Web_JobSeeker_ApplicationManager_20140901
2019 252 NIJ mobile OJJDP desktop and Mobile	252, 252, 252	2019 252 NIJ Mobile Browse (1) (1) ,   2019 252 OJJDP Desktop 20191211 (1) ,   2019 252 OJJDP Mobile 20191211 (1)
2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17	002	2020 002 Q_VAMyHealtheVet_Web_Browse_2020_1_17
2020 009 TWE Results Survey v3	009	2020 009 TWE Results Survey v3
2020 033 OJP Crime Solutions Website Feedback Survey 20200731	033	2020 033 OJP Crime Solutions Website Feedback Survey 20200731
2020 011 BJA Desktop	011	2020 011 BJA Desktop
2020 014 OJP Mobile	014	2020 014 OJP Mobile
2020 022 TEOS Survey 2020-05-05 IRS	022	2020 022 TEOS Survey 2020-05-05 IRS
2020 010 OJJDP Email Newsletter	010	2020 010 OJJDP Email Newsletter
2019 018 Oceanservice.noaa.gov Desktop Informational	018	2019 018 Oceanservice.noaa.gov Desktop Informational
Mapping and Questionnaire Documents IA 30723 A2 (NRC)	30723	Q_Nrc_Web_Browse_20170421
2019 019 VA FeedbackSurvey	019	2019 019 VA FeedbackSurvey
Mapping and Questionnaire Documents IA 30839 A0 (SAMHSA)	Q_SAMHSAMain_Web_Browse_201760518, Q_SAMHSAStore_Web_Browse_20160518	Q_SAMHSAMain_Web_Browse_201760518 ,   Q_SAMHSAStore_Web_Browse_20160518
Mapping and Questionnaire Documents IA 30733 A1 (NOAA)	30733	NGS NOAA V3 - 12-20-2017_DOT
Mapping and Questionnaire Documents IA 30739 A1 (FEMA)	30739, 30739, 30739	Q_FEMA NFIP_Claim Examination_20180507_DOT ,   Q_FEMA NFIP_Claim Filing Functional_20180507_DOT ,   Q_NFIP_Claim Adjustment_20180507_DOT
Mapping and Questionnaire Documents IA 30737 A1 (CIS)	30737, 30737, 30737, 30737	Q_E-Verify v2_Web_Browse_20171121_DOT ,   Q_eVerifyI9_Web_Browse_20140708 ,   Q_eVerifySAVEv2_Web_Browse_20181101_DOT ,   Q_myE-Verify-Self Check v2_Web_Browse_20171121_DOT
Mapping and Questionnaire Documents IA 30669 A3 (Dept of Treasury)	30669 M3, 30669	Q_TreasMha_Mobile_Browse_20170221 ,   MHA Questionnaire 12.17.15_DOT
Mapping and Questionnaire Documents IA 30809 (ABMC)	Q_ABMCv2_Web_Browse_20160411_DOT	Q_ABMCv2_Web_Browse_20160411_DOT
Mapping and Questionnaire Documents IA 30802 A0 (DLA)	Q_DLA_Web_Browse_20171129	Q_DLA_Web_Browse_20171129
2019 027 NOS Website Feedback Survey 30736	027	2019 027 NOS Website Feedback Survey 30736
2019 234 Q_SSA-mySSA_Web_AccountManagement_JULY 2019	234	2019 234 Q_SSA-mySSA_Web_AccountManagement_JULY 2019
2019 254 of Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)	254	Q_EPA_Web_Browse_20190402_DL_December19 (004) (002)
2020 041 IRS Free File survey	041	2020 041 IRS Free File survey
2020 043 Survey Mapping Document DHA Tricare MTF survey	043	2020 043 Survey Mapping Document DHA Tricare MTF survey
2020 036 SEC Main Web Browse_20200714_DOT	036	2020 036 SEC Main Web Browse_20200714_DOT
2019 014 SEC IAPD Mobile 2017 Questionnaire	014	2019 014 SEC IAPD Mobile 2017 Questionnaire
2019 012 Q_IRS TDC Chat_20191116	012	2019 012 Q_IRS TDC Chat_20191116
2020 004 SBA Mapping Document (Spanish Survey November 2019)	004	2020 004 SBA Mapping Document (Spanish Survey November 2019)
2020 029 DHS CRC v2 desktop Michelle mockup CRC Mobile Informational_Michelle mockup	029, 029	029 CRC Mobile Informational_Michelle mockup with changes June 23 ,   029 DHS CRC v2 desktop Michelle mockup with changes June 23
Mapping and Questionnaire Documents IA 30830 A0 (ITC)	USITC v3_9.25.15_DOT	USITC v3_9.25.15_DOT
Mapping and Questionnaire Documents IA 30614 A4 (FSIS)	30614 M4	Q_FSIS_Web_Browse_20150515
Mapping and Questionnaire Documents IA 30660 A3 (OWH	30660, 30660, 30660, 30660, 30660	Q_GirlsHealth_Web_Browse_20170808 ,   Q_GirlsHealthV3_Mobile_Browse_20170808 ,   Q_WomensHealthV3_Web_Browse_20181129_DOT ,   Q_WomensHealthV3_Web_Browse_20181129_DOT_1 ,   Women's Health Desktop SP_20181116_DOT
Mapping and Questionnaire Documents IA 30673 A3 (NASS)	30673	Q_USDA-NASS_Web_Browse_20180611_DOT
Mapping and Questionnaire Documents IA 30812 A0 (AHRQ)	AHRQ USPSTF Q'aire 7-30-15_DOT, Q_AHRQEnterprise_Web_Browse_20180117_DOT	AHRQ USPSTF Q'aire 7-30-15_DOT ,   Q_AHRQEnterprise_Web_Browse_20180117_DOT
Mapping and Questionnaire Documents IA 30813 A0 (NIH)	Q_NHLBI_Browse_20170816	Q_NHLBI_Browse_20170816
Mapping and Questionnaire Documents IA 30814 A0 (CDC)	Q_CDCNPIN_Web_Browse_20170807, CDC OMB Form 11.13.2018 IA 30814 A0, Q_CDCMobile_Mobile_Browse_20170807_DOT, Q_CDCNPIN_Mobile_Browse_20170807	CDC OMB Form 11.13.2018 IA 30814 A0 ,   Q_CDCMobile_Mobile_Browse_20170807_DOT ,   Q_CDCNPIN_Mobile_Browse_20170807 ,   Q_CDCNPIN_Web_Browse_20170807
2020 003 IRS TDC Chat Survey (Spanish) (3)	003	2020 003 IRS TDC Chat Survey (Spanish) (3)
2019 022 IRS Withholding Calculator Feedback Survey	022	2019 022 IRS Withholding Calculator Feedback Survey
2020 048 Q_FOIA - Desktop PX_Survey_20201112	048	2020 048 Q_FOIA - Desktop PX_Survey_20201112
2019 241 FEMA RMD Risk MAP Meeting_rev_10.03.19 (1)	241	2019 241 FEMA RMD Risk MAP Meeting_rev_10.03.19 (1)
2019 253 USPTO Patent, OCIO and OCFO Contact Centers V2	253	2019 253 USPTO Patent, OCIO and OCFO Contact Centers V2
2020 020 Q_DoDEA_Web_Browse Updated by Michelle April 3 2020	020	2020 020 Q_DoDEA_Web_Browse Updated by Michelle April 3 2020
2020 035 SEC Main Mobile_20200714_DOT	035	2020 035 SEC Main Mobile_20200714_DOT
2020 034 Q_DoDEA_Web_Browse_2020-05-21_DOT (1)	034	2020 034 Q_DoDEA_Web_Browse_2020-05-21_DOT (1)
2020 032 TWE Pre-Results Survey v2	032	2020 032 TWE Pre-Results Survey v2
2020 023 Spanish Feedback Survey 06MAR2020 2020 023 COLA Outreach Survey 03MAR2020	023, 023	2020 023 COLA Outreach Survey 03MAR2020 ,   2020 023 COLA Outreach Survey 03MAR2020
2019 244 TWE Feedback Survey IRS	244	2019 244 TWE Feedback Survey IRS
2019 029 Noridian Feedback Survey_Enrollment (2) 30628	029, 029, 029, 029, 029, 029, 029, 029, 029	2019 029 Noridian Feedback Survey_Enrollment (2) 30628 ,   Noridian Feedback Survey_MR AB 30628 ,   Noridian Feedback Survey_MR DME PA 30628 ,   Noridian Feedback Survey_MR DME TPE (1) 30628 ,   Noridian Feedback Survey_PCC 30628 ,   Noridian Feedback Survey_POE Events 30628 ,   Noridian Feedback Survey_POE Page 30628 ,   Noridian Feedback Survey_Recoup 30628 ,   Noridian Feedback Survey_Redeter (1) 30628
Mapping and Questionnaire Documents IA 30709 A2 (USDA)	30709	Forest Service Functional 20181002_DOT (1)
2019 013 TTB Feedback Survey	013	2019 013 TTB Feedback Survey
2019 019 NMFS-FeedbackSurvey-2018-12-20 (1)	019	2019 019 NMFS-FeedbackSurvey-2018-12-20 (1)
2019 236 Q_NIJ_Web_Browse_2019 08 19.xlsx	236	2019 236 Q_NIJ_Web_Browse_2019 08 19
2020 038 Crime Solutions Desktop Browse resubmit	038	2020 038 Crime Solutions Desktop Browse resubmit
2019 233 MHS Genesis Beneficiaries Feedback Survey	233	2019 233 MHS Genesis Beneficiaries Feedback Survey
2020 039 SSA mySSA Web AccountManagement_09_24_20	039	2020 039 SSA mySSA Web AccountManagement_09_24_20
2020 045 MyHealtheVet Mobile Nov 2020 (1)	045	2020 045 MyHealtheVet Mobile Nov 2020 (1)
Mapping and Questionnaire Documents IA 30833 A0 (ED)	Q_ED.gov_Web_Browse_20170228	Q_ED.gov_Web_Browse_20170228
Mapping and Questionnaire Documents IA 30829 A0 (DOJ)	Q_PbgcCsat_Web_Browse_2018040610_DOT, Q_PbgcMyPaa_Web_Browse_20180614_DOT, Q_PbgcGov_Web_Browse_20180410_DOT	Q_PbgcCsat_Web_Browse_2018040610_DOT ,   Q_PbgcGov_Web_Browse_20180410_DOT ,   Q_PbgcMyPaa_Web_Browse_20180614_DOT
Mapping and Questionnaire Documents IA 30633 A4 (NSF)	30633 M4	Q_NSF_Web_Browse_20180205_DOT
Mapping and Questionnaire Documents IA 30736 A1 (NOAA)	30736, 30736	NOAA Fisheries Desktop Informational20181116_DOT (1) ,   NOAA Fisheries Mobile Informational 091917_DOT
Mapping and Questionnaire Documents IA 30681 A4 (CIS)	30681, 30681, 30681, 30681	Q_USCISMobile_Mobile_Browse_20180813_DOT ,   Q_USCISMobileSP_Mobile_Browse_20180813_DOT ,   Q_USCISSPv2_Web_Browse_20180813_DOT ,   Q_USCISv2_Web_Browse_20180813_DOT
Mapping and Questionnaire Documents IA 30683 A3 (OCPL)	30683	SBA Browse V2 - 01-05-2018_DOT
Mapping and Questionnaire Documents IA 30806 A0 (NLM)	Q_AIDSInfo_Web_Browse_20170807 (1), Q_AIDSInfo_Mobile_Browse_20170807, Q_infoSIDA_Web_Browse_20170807	Q_AIDSInfo_Mobile_Browse_20170807 ,   Q_AIDSInfo_Web_Browse_20170807 (1) ,   Q_infoSIDA_Web_Browse_20170807
Mapping and Questionnaire Documents IA 30807 A0 (NIH)	Q_NIH-Main_Web_Browse_20160511	Q_NIH-Main_Web_Browse_20160511
Mapping and Questionnaire Documents IA 30747 A1 (USDA)	USDA NAL Browse 2017_DOT (1)	USDA NAL Browse 2017_DOT (1)
2019 235 Security Administration	235, 235, 235, 235, 235, 235, 235	2019 235 Q_SSADisability_Web_AccountManagement_2019_8_19 ,   2019 235 Q_SSABSO_Web_AccountManagement_2019_8_19 ,   2019 235 Q_SSAExtraHelp_Web_AccountManagement_2019_8_19 ,   2019 235 Q_SSAiAppeals_Web_AccountManagement_2019_8_19 ,   2019 235 Q_SSAiClaim_Web_AccountManagement_2019_8_19 ,   2019 235 Q_SSA-mySSA_Web_AccountManagement_08_19_2019 (1) ,   2019 235 Q_SSARetirementEstimator_Web_AccountManagement_2019_8_19
2019 240 In-Page-Feedback.Tool.Qs-ForeSee NIDCR (1)	240	2019 240 In-Page-Feedback.Tool.Qs-ForeSee NIDCR (1)
2020 025 1090-0008 Survey Mapping Document (VHA) IA 30820 A0_draft (1)	025	2020 025 1090-0008 Survey Mapping Document (VHA) IA 30820 A0_draft (1)
2020 047 TDC Appeals Secure Messaging Survey vfinal2	047	2020 047 TDC Appeals Secure Messaging Survey vfinal2
2020 017 ForeseeSurvey_COVID19	017	2020 017 ForeseeSurvey_COVID19
2020 021 Feedback Surveys OJP	021	2020 021 Feedback Surveys OJP
2020 005 BJS Mobile Browse	005	2020 005 BJS Mobile Browse

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,250,000	3,750,000	0	0	-2,500,000	0
Annual Time Burden (Hours)	52,083	156,250	0	0	-104,167	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $8,268,915

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/31/2018

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