Information Collection

Customer Experience Survey

IC 240137 under ICR 201912-3220-006 · OMB 3220-0192.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3220-0192 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form T-36 (Propose Customer Experience Survey	Form
Form T-36 (Propose Customer Experience Survey Telephone Customer Experience Survey.pdf	Form
3220-0192 - Generic IC Justification.docx 3220-0192 - Generic IC Memo	IC Document

IC Title:

Customer Experience Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form T-36 (Proposed)	Customer Experience Survey	Telephone Customer Experience Survey.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: RRBâ55, Contact Log

FR Citation: 79 FR 58874

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
3220-0192 - Generic IC Memo	3220-0192 - Generic IC Justification.docx	03/11/2020

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