Information Collection

AVA Feedback Form

IC 261324 under ICR 202309-1103-001 · OMB 1103-0117.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0117 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ADA Feedback Form.docx	Other-Feedback Form
ADA Feedback Form.docx	Other-Feedback Form
1103-0117 Generic Clearance ADA-gov-PRA-request-073123.docx 1103-0117 Generic Clearance Request	IC Document
1103-0117 Generic Clearance ADA-gov-PRA-request-073123.docx 1103-0117 Generic Clearance Request	IC Document

IC Title:

AVA Feedback Form

Agency IC Tracking Number:

IC Status: Unchanged

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-Feedback Form			ADA Feedback Form.docx	ADA.gov	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300,000	300,000
Annual IC Time Burden (Hours)	15,000	15,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1103-0117 Generic Clearance Request	1103-0117 Generic Clearance ADA-gov-PRA-request-073123.docx	07/31/2023

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