Form 201 User Survey

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

OGE Form 201 Request for Ethics Records User Survey Questions

OMB: 3209-0010

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OGE Form 201 Request for Ethics Records User Survey Questions



  1. How easy was it to understand the instructions for completing the form.


  • Very easy

  • Easy

  • Neither easy nor difficult

  • Difficult

  • Very difficult


  1. Where you able to accomplish what you wanted to do on the site today?


  • Yes

  • No


  1. If you weren’t able to accomplish everything you wanted to, please tell us why? 


[open text box]


  1. Do you identify as someone from an underserved community? 


The term “underserved communities” refers to populations sharing a particular characteristic, as well as geographic communities, who have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life. In the context of the Federal workforce, this term includes individuals who belong to communities of color, such as Black and African American, Hispanic and Latino, Native American, Alaska Native and Indigenous, Asian American, Native Hawaiian and Pacific Islander, Middle Eastern, and North African persons. It also includes individuals who belong to communities that face discrimination based on sex, sexual orientation, and gender identity (including lesbian, gay, bisexual, transgender, queer, gender non-conforming, and non-binary (LGBTQ+) persons); persons who face discrimination based on pregnancy or pregnancy-related conditions; parents; and caregivers. It also includes individuals who belong to communities that face discrimination based on their religion or disability; first-generation professionals or first-generation college students; individuals with limited English proficiency; immigrants; individuals who belong to communities that may face employment barriers based on older age or former incarceration; persons who live in rural areas; veterans and military spouses; and persons otherwise adversely affected by persistent poverty, discrimination, or inequality. Individuals may belong to more than one underserved community and face intersecting barriers.


  • Yes

  • No

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorJennifer Matis
File Created2024:11:24 15:37:21Z

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