Information Collection

SEPA Customer Experience Survey

IC 276498 under ICR 202108-1910-003 · OMB 1910-5160.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5160 can be found here:

Documents and Forms

Document Name Document Type
SEPA CES Questions - MS Form.pdf Other-Survey
Generic Clearance Template - SEPA.pdf Generic Submission Template IC Document
SEPA Customer List for 2025 CES.docx Customer List IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SEPA Customer Experience Survey	Agency IC Tracking Number:	Amanda Adams

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
Other-Survey			SEPA CES Questions - MS Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 471	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	471	471
Annual IC Time Burden (Hours)	118	118
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Submission Template	Generic Clearance Template - SEPA.pdf	07/17/2025
Customer List	SEPA Customer List for 2025 CES.docx	07/17/2025

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

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