SCSEP Employer and Host Agency Customer Satisfaction Surveys

Senior Community Service Employment Program (SCSEP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1205-0040 can be found here:

Documents and Forms

Document Name Document Type
Form ETA 9124B SCSEP Employer and Host Agency Customer Satisfaction Surveys Form and Instruction
ETA 9124B Host Agency Customer Satisfaction Survey ETA 9124B_HOST AGENCY Survey_20180228.pdf Form and Instruction
ETA 9124C Employer Customer Satisfaction Survey ETA 9124C_EMPLOYER Survey_20180228.pdf Form and Instruction
ETA 9124A SCSEP Participant Survey Customer Satisfaction ETA 9124A_PARTICIPANT Survey_20180228.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	SCSEP Employer and Host Agency Customer Satisfaction Surveys	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR Part 641 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	ETA 9124B	Host Agency Customer Satisfaction Survey	ETA 9124B_HOST AGENCY Survey_20180228.pdf	Yes	No	Paper Only
Form and Instruction	ETA 9124C	Employer Customer Satisfaction Survey	ETA 9124C_EMPLOYER Survey_20180228.pdf	Yes	No	Paper Only
Form and Instruction	ETA 9124A	SCSEP Participant Survey Customer Satisfaction	ETA 9124A_PARTICIPANT Survey_20180228.pdf	Yes	No	Paper Only

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20,800	-1,200	22,000
Annual IC Time Burden (Hours)	3,328	-340	3,668
Annual IC Cost Burden (Dollars)	0	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.