Information Collection

Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey

IC 246087 under ICR 202012-2010-001 · OMB 2010-0042.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5800-017 Office of Administrative Law Judges Alternative Dispute Resolution Process User Survey	Form
5800-017 User Survey 2017-03-23 - adr survey - omb approved.docx	Form
5800-017 User Survey 2017-03-23 - adr survey - omb approved.docx	Form
2020-12-31 - generic survey approval request - adr survey.docx Justification	IC Document
2020-12-31 - generic survey approval request - adr survey.docx Justification	IC Document

IC Title:

Agency IC Tracking Number:

2434.117

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	5800-017	User Survey	2017-03-23 - adr survey - omb approved.docx		No		Paper Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	2020-12-31 - generic survey approval request - adr survey.docx	03/05/2021

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