Information Collection

A11-24-3 Medallia - Online Account Survey

IC 266834 under ICR 202306-1545-013 · OMB 1545-2290.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
A11-24-3 Medallia - Online Account Survey Attachment.xlsx	Other-Attachment
A11-24-3 Medallia - Online Account Survey Supporting Statement.docx A11-24-3 Medallia - Online Account Survey Supporting Statement	IC Document

IC Title:

Agency IC Tracking Number:

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-Attachment					Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A11-24-3 Medallia - Online Account Survey Supporting Statement		04/12/2024

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

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