Information Collection

EBSA Participant Assistance Program Customer Survey

IC 238857 under ICR 202502-1210-006 · OMB 1210-0161.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
US_DOL_EBSA_CE3_2025_outbound_02_2025 Update.docx	Other-Survey Instrument
US_DOL_EBSA_CE3_2025_outbound_02_2025 Update.docx	Other-Survey Instrument

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Survey Instrument					No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,081

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	14,081	14,081
Annual IC Time Burden (Hours)	2,347	2,347
Annual IC Cost Burden (Dollars)	0	0

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.

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