Information Collection

[PHIC] 2025 PHAP Program Separation Survey

IC 277461 under ICR 202504-0920-025 · OMB 0920-1163.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1163 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1163 PHAP Program Separation Survey [PHIC] 2025 PHAP Program Separation Survey	Form and Instruction
0920-1163 PHAP Program Separation Survey Att1_PHAP ProSep_Surv_word.docx	Form and Instruction
Att2_PHAP ProSep_Surv_scr.pdf PHAP Program Separation Survey - Screenshots	IC Document
GenIC Req PHAP ProSep_Surv.docx 0920-1163 GenIC Request Template	IC Document
Att3_PHAP ProSep_Surv InvRemEm.docx Email Invitation/Reminder Email	IC Document

IC Title:

[PHIC] 2025 PHAP Program Separation Survey

Agency IC Tracking Number:

0920-25-0170

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	0920-1163			N/A	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	100	100
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PHAP Program Separation Survey - Screenshots		09/09/2025
0920-1163 GenIC Request Template		09/09/2025
Email Invitation/Reminder Email		09/09/2025

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

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