Information Collection

Verification Division Customer Service Surveys (Qualtrics)

IC 263042 under ICR 202302-1615-002 · OMB 1615-0121.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Qualtrics Survey Questions (6) 20230828.docx	Other-Verification Customer Service
GC mini-Supporting Satement-Qualtrics Website Survey final FY23 20230829.docx GC Mini-SS - Verification Surveys	IC Document

IC Title:

Agency IC Tracking Number:

OMB-66

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
Other-Verification Customer Service Surveys			Qualtrics Survey Questions (6) 20230828.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: 15,500

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	15,500	15,500
Annual IC Time Burden (Hours)	1,550	1,550
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GC Mini-SS - Verification Surveys	GC mini-Supporting Satement-Qualtrics Website Survey final FY23 20230829.docx	10/26/2023

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