EBSA Participant Assistance Program Customer Survey

OMB 1210-0161

The purpose of this data collection effort is to solicit inquirers’ feedback and compile reports on the applicability and utility of EBSA’s Participant Assistance Program. This survey will collect customer satisfaction data for a sample of private citizens who call into the participant assistance program to ask about their private sector employer provided benefits such as pensions, retirement savings, and health benefits.

The latest form for EBSA Participant Assistance Program Customer Survey expires 2023-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
GPRA Resources - DOL website.pdf Supplementary Document
PUBLIC LAW 111–352 -GPRA Modernization Act of 2010.pdf Supplementary Document
Public Law 103-62 - GPRA.pdf Supplementary Document
30-day FRN (1210-0161) published.pdf Supplementary Document
60-day FRN (1210-0161) published.pdf Supplementary Document
signed_PRA Signature Form_EBSA_(2021_0928).pdf Supplementary Document
2021 PAP Satisfaction Survey - Part A and B 9-20-2021 (clean).docx Supporting Statement B
2021 PAP Satisfaction Survey - Part A and B 9-29-2021 clean.docx Supporting Statement A
EBSA Participant Assistance Program Customer Survey Other-Survey Instrument

All Historical Document Collections

202109-1210-001 Approved with change	Revision of a currently approved collection	2021-09-30
201912-1210-001 Approved without change	New collection (Request for a new OMB Control Number)	2020-04-23