Participant Customer Satisfaction – ETA-9124A

Senior Community Service Employment Program (SCSEP)

Documents and Forms

Document Name Document Type
Form ETA 9124A Participant Customer Satisfaction – ETA-9124A Form
ETA 9124A Participant Survey ETA-9124A_PARTICIPANT Survey.pdf Form
ETA 9124A Participant Survey ETA-9124A_PARTICIPANT Survey.pdf Form

Information Collection (IC) Details

IC Title:	Participant Customer Satisfaction – ETA-9124A	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 641

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ETA 9124A	Participant Survey	ETA-9124A_PARTICIPANT Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,712	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,712	8,712
Annual IC Time Burden (Hours)	1,394	1,394
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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