Information Collection Request

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

ICR 202406-1103-005 · OMB 1103-0117 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1103-0117 Course Evaluation Survey Form and Instruction New Repair queued
Form 1103-0117 CRI Customer Satisfaction Survey Form and Instruction New Repair queued
Form 103-0117 Long-Term Post-TA Impact Survey Form and Instruction New Repair queued
Gen IC Template-062724-RA.docx Supplementary Document Uploaded 2024-06-28 Repair queued
1103-0117 Nonmaterial change request for (09222023).docx Justification for No Material/Nonsubstantive Change Uploaded 2023-09-22 Repair queued
1103-0117 Supporting Statement A (04102023) final.docx Supporting Statement A Uploaded 2023-04-11 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
279222 CRI Training Evaluation Survey Form and Instruction NewCourse Evaluation Survey
279221 CRI Customer Satisfaction Survey Form and Instruction NewCRI Customer Satisfaction Survey
279220 Long Impact Survey Gen IC Form and Instruction NewLong-Term Post-TA Impact Survey
269090 ADA Feedback Form Other- New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2027 36 Months From Approved 04/30/2026
300,000 0 310,200
15,000 0 101,827
0 0 75





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4
table that charts list of burden
IC Title Form No. Form Name
ADA Feedback Form
CRI Customer Satisfaction Survey 1103-0117
CRI Training Evaluation Survey 1103-0117
Long Impact Survey Gen IC 103-0117

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 300,000 310,200 0 -10,200 0 0
Annual Time Burden (Hours) 15,000 101,827 0 -86,827 0 0
Annual Cost Burden (Dollars) 0 75 0 -75 0 0


Reginfo record details
  No