Verification Division Customer Service Surveys (Qualtrics)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Verification Division Customer Service Surveys (Qualtrics)	Agency IC Tracking Number:	OMB-66

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-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 %

	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

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.