Information Collection

Mediation Services Participant Questionnaire - Private Sector Respondents

IC 265974 under ICR 202403-3320-002 · OMB 3320-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3320-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3320-0003 (B) Mediation Services Participant Questionnaire - Private Sector Respondents	Form and Instruction
3320-0003 (B) Mediation Services Participant Questionnaire Mediation Services Participant Questionnaire - 0003B.pdf	Form and Instruction
3320-0003 (B) Mediation Services Participant Questionnaire Mediation Services Participant Questionnaire - 0003B.pdf	Form and Instruction

IC Title:

Mediation Services Participant Questionnaire - Private Sector Respondents

Agency IC Tracking Number:

0003B

Is this a Common Form? No

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
Form and Instruction	3320-0003 (B)	Mediation Services Participant Questionnaire	Mediation Services Participant Questionnaire - 0003B.pdf		Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 10

Affected Public: Private Sector

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

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	10	10
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	190	190

Documents for IC

table that charts IC Documents
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.