Information Collection

USCIS Mobile/Desktop Satisfaction Survey (Qualtrics)

IC 245207 under ICR 202006-1615-004 · OMB 1615-0121.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0121 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1615-0121 USCIS Mobile/Desktop Satisfaction Survey (Qualtrics)	Form and Instruction
1615-0121 USCIS Mobile Satisfaction Survey (Qualtrics) Qualtrics mobile-survey-2020.docx	Form and Instruction
1615-0121 83C mobile survey.docx Mini-Supporting Statement	IC Document

IC Title:

USCIS Mobile/Desktop Satisfaction Survey (Qualtrics)

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 and Instruction	1615-0121	USCIS Mobile Satisfaction Survey (Qualtrics)	Qualtrics mobile-survey-2020.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: 22,583

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22,583	22,583
Annual IC Time Burden (Hours)	3,162	3,162
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mini-Supporting Statement	1615-0121 83C mobile survey.docx	01/22/2021

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