View Information Collection (IC)

View Information Collection (IC)

IC Title:	Gallup LBC Survey Questionairre	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SV-2007-0021	Gallup LBC Survey Questionaire 07-23-2008	Gallup OMB LBC Survey Questionnaire Exp 7.23.08.doc		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	8,000	0	8,000	0	0	0
Annual IC Time Burden (Hours)	1,333	0	1,333	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Gallup CA Responses to OMB Questions	Gallup CA Responses to OMB Questions 07.23.08.docx	07/23/2008

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