USCIS Mobile/Desktop Satisfaction Survey (Qualtrics)

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⚠️ Notice: This information collection may be referencing outdated material.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 1615-0121 can be found here:

Documents and Forms

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

Information Collection (IC) Details

IC Title:	USCIS Mobile/Desktop Satisfaction Survey (Qualtrics)	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
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 %

	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

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.