Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2011 477 NIST Ambulance Design FINAL New 30 45 0 Form 477 NIST Ambulance Design FINAL 477 NIST Ambulance Design FINAL
284 CFI US Mint Treasury New 250 50 0 Form 284 CFI 2009 US Mint Treasury
288 VHA Outpatient 289 VHA Inpatient 290 Rural Dev New 750 150 0 Form 288 CFI 2009 VHA Outpatient
Form 289 CFI 2009 VHA Inpatient
Form 290 CFI 2010 Rural Development
294 FAA Ofc of Airports, 295 FinCEN Secure Outreach, 296 FinCEN Compliance, 297 FinCEN Regulatory New 1000 167 0 Form 294 FAA OoA 294 FAA Ofc of Airports
Form 295 FinCen Secure 295 FinCEN Secure Outreach WebCBRS
Form 296 FinCEN Compliance 296 FinCEN Compliance MOU Final
Form and Instruction 297 FinCEN Regulatory 297 FinCEN Regulatory Resource Center
298 MCHB New 250 42 0 Form and Instruction 298 MCHB 298 HRSA MCHB Resource Center 2010
303 PBGC Participant Caller 304 PBGC Retiree Caller New 500 83 0 Form and Instruction 303 PBGC Participant 303 PBGC Participant Caller
Form and Instruction 304 PBGC Retiree 304 PBGC Retiree Callers
307 FAA Pilots 308 Carrier Ops 309 Mechanics New 750 125 0 Form 2010 307 FAA Gen Av Pilots 2010 307 FAA Gen Av Pilots
Form 2010 308 FAA Carrier Ops 2010 308 FAA Carrier Ops
Form 2010 309 FAA Mechanics 2010 309 FAA Mechanics
317 2010 ED CFO CQ's 5_26 318 2010 NWS FINAL 319 FEMA QS FINAL 320 PBGC QS 2010 Final 321 USCIS-EVerify 2010 QS New 3350 558 0 Form 317 2010 ED CFO FINAL CORE AND CQ's 5_26 317 2010 ED CFO FINAL CORE AND CUSTOM QUESTIONS 5_26
Form 318 2010 NWS Overall Measure FINAL 318 2010 NWS Overall Measure FINAL
Form 319 FEMA QS and Local Officials Final 319 FEMA QS and Local Officials FINAL
Form 320 PBGC Premium Filer Questionnaire 2010 Final 320 PBGC Premium Filer Questionnaire 2010 Final
Form 321 USCIS-EVerify 2010 Questionnaire_Final 321 USCIS-EVerify 2010 Questionnaire_Final
325 TSSD 6-2-2010 326 RPPD 6-11-2010 327 IPD 5-27-2010 328NASA New 9800 1633 0 Form 325 TSSD 6-2-2010 325 TSSD 6-2-2010
Form 326 RPPD 6-11-2010 326 RPPD 6-11-2010
Form 327 IPD 5-27-2010 327 IPD 5-27-2010
Form 328 NASA CSI Survey 2010 Final 328 NASA CSI Survey 2010 Final
Form 330 FEMA 330 FEMA 2010 Questionnaire
Form 329 FAA ATO 329 FAA ATO 2010
Form 331 SEC 331 SEC OIEA Final
Form 332 DOJ COPS 332 DOJ COPS 2010
335 State and Local Q's 336, 337 HRSA BCRS NHSC 338 FinCen New 1000 167 0 Form 335 2010 State and Local Questionnaire - Final 335 2010 State and Local Questionnaire - Final
Form 336 HRSA BCRS NHSC Participant Questionnaire_Final 336 HRSA BCRS NHSC Participant Questionnaire_Final
Form 337 HRSA BCRS NHSC Partner Questionnaire_Final 337 HRSA BCRS NHSC Partner Questionnaire_Final
Form 338 2010 FinCEN Domestic Analytic Products Survey 338 2010 FinCEN Domestic Analytic Products Survey Final 3
342 SEC OIEA Jul 2010 Questionnaire Call Center Questionnaire New 250 42 0 Form 342 SEC OIEA Jul 2010 Questionnaire Call Center Qs 342 SEC OIEA Jul 2010 Questionnaire Call Center Qs
348 CPSC.gov 8-24-2010, 349 CQs for OMB 8-9-2010 to 8-25-2010, 350 FDA Email Model - 8.11.10 FINAL New 750 125 0 Form 348 CPSC.gov Questionnaire 8-24-2010 348 CPSC.gov Questionnaire 8-24-2010
Form 349 CQs for OMB 8-9-2010 to 8-25-2010 349 CQs for OMB 8-9-2010 to 8-25-2010
Form 350 FDA Email Model - 8.11.10 FINAL 350 FDA Email Model - 8.11.10 FINAL
351-361 NCES_ Passport Q's_ EEOC_ IRS Small and Self Employed Filers_ODA_ LSA_Senior Corps New 2750 367 0 Form 351 final NCES Questionnaire 2010 351 final NCES Questionnaire 2010
Form 352 Passport Q's AUG 23 352 Passport Q's AUG 23
Form 353 EEOC Contract Customer Satisfaction Survey 353 EEOC Contract Customer Satisfaction Survey
Form 354 2010 IRS Small and Self Employed Filers Survey 354 2010 IRS Small and Self Employed Filers Survey
Form 355 SBA ODA Customer Satisfaction Survey 2010 355 SBA ODA Customer Satisfaction Survey 2010
Form 356 LSA Q's Final 356 LSA Q's Final
Form 357 Senior corps Q's_Final 357 Senior corps Q's_Final
Form 358 State and National Q's final 358 State and National Q's final
Form 359 VISTA Q's final 359 VISTA Q's final
Form 360 NCCC 2010 final Wave with 2 additional Q's 360 NCCC 2010 final Wave with 2 additional Q's
Form 361 HRSA BCRS Partner Q's final additional 361 HRSA BCRS Partner Q's final additional
367 NCA , 368 FCIC Q's 2010 New 500 83 0 Form 367 NCA Customer Satisfaction Survey 367 NCA Customer Satisfaction Survey
Form 368 FCIC Customer Satisfaction Questionnaire 2010 368 FCIC Customer Satisfaction Questionnaire 2010
374 - 376 IRS DTIC AFI New 2650 663 0 Form and Instruction 374 IRS 374 IRS Wand I E and Paper Filers for 2010
Form and Instruction 375 DTIC 375 DTIC
Form and Instruction 376 AFI 376 AFI Comm Svcs
379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final New 750 125 0 Form 379 IRS LB & I Questionnaire 379 IRS LB & I Questionnaire
Form 380 VHAInpatient_Survey_10_Final 380 VHAInpatient_Survey_10_Final
Form 381 VHAOutpatient_Survey_10_Final 381 VHAOutpatient_Survey_10_Final
388 Dept of Labor EBSA Q's FINAL 389 Tricare survey Outpatient 390 Tricare survey Inpatient New 750 125 0 Form 388 Dept of Labor EBSA Questionnaire FINAL 388 Dept of Labor EBSA Questionnaire FINAL
Form 389 Tricare survey Outpatient 389 Tricare survey Outpatient
Form 390 Tricare survey Inpatient 390 Tricare survey Inpatient
395 Regulatory Resource Center Customer Survey 2011_FINAL, 396 FinCEN Secure Outreach_WebCBRS Survey 2011_FINAL New 500 83 0 Form 2011 395 Regulatory Resource Center Customer Surve 2011 395 Regulatory Resource Center Customer Survey 2011_FINAL.doc
Form 2011 396 FinCEN Secure Outreach_WebCBRS Survey 201 2011 396 FinCEN Secure Outreach_WebCBRS Survey 2011_FINAL.doc
397 FinCEN Compliance MOU Customer Survey 2011_draft, 402 ACSI Annual Customer Satisfaction Survey FINAL New 500 63 0 Form 397 FinCEN Compliance MOU Customer Survey 2011_dra 397 FinCEN Compliance MOU Customer Survey 2011_draft
Form 402 ACSI Annual Customer Satisfaction Survey FINAL 402 ACSI Annual Customer Satisfaction Survey FINAL
403 Customer Satisfaction Questionnaire.docx New 250 83 0 Form 403 Customer Satisfaction Questionnaire.docx 403 Customer Satisfaction Questionnaire.docx
409 VHA ChampVA 2011 Q's, 410 DOJ COPS TTA , 411PBGC Participant Caller ACSI Instrument 2011 FINAL, 412PBGC Retiree ACSI Instrument 2011 FINAL, 413MINT ACSI Annual Customer Satisfaction Survey FINAL New 1250 208 0 Form 409 VHA ChampVA 2011 Q's 409 VHA ChampVA 2011 Q's
Form 410 DOJ COPS TTA Recip_Quart_FY2011_FINAL 410 DOJ COPS TTA Recip_Quart_FY2011_FINAL
Form 411 PBGC Participant Caller ACSI Instrument 2011 F 411 PBGC Participant Caller ACSI Instrument 2011 FINAL
Form 412 PBGC Retiree ACSI Instrument 2011 FINAL 412 PBGC Retiree ACSI Instrument 2011 FINAL
Form 413 MINT ACSI Annual Customer Satisfaction Survey 413 MINT ACSI Annual Customer Satisfaction Survey FINAL Mar9
423 DOJ COPS Publication MonthlySurvey FY2011 UPDATED 3_18 New 250 42 0 Form 423 DOJ COPS Publication MonthlySurvey FY2011 UPDA 423 DOJ COPS Publication MonthlySurvey FY2011 UPDATED 3_18
428 PBGC Premium Filer Q's 2011 F, 429 VBA 2011 Insurance Claims Q's F, 430 VBA 2011 Call Center Q's F New 750 125 0 Form 428 PBGC Premium Filer Q's 2011 F 428 PBGC Premium Filer Q's 2011 F
Form 429 VBA 2011 Insurance Claims Q's Final 429 VBA 2011 Insurance Claims Q's Final
Form 430 VBA 2011 Call Center Q's Final 430 VBA 2011 Call Center Q's Final
434 FEMA_Q's_Public_4_21_11; 435 FEMA_Q's_Local_Officials_4_21_11; 436 NWS Overall Measure 042211_FINAL; 437HRSA BCRS NHSC 2011 Partic Q's_FINAL; 438 HRSA BCRS NHSC 2011 Partner Q's_FINAL New 1250 313 0 Form 434 FEMA_Questionnaire_Public_4_21_11 434 FEMA_Questionnaire_Public_4_21_11
Form 435 FEMA_Questionnaire_Local_Officials_4_21_11 435 FEMA_Questionnaire_Local_Officials_4_21_11
Form 436 NWS Overall Measure 042211_FINAL 436 NWS Overall Measure 042211_FINAL
Form 437 HRSA BCRS NHSC 2011 Participant Questionnaire_ 437 HRSA BCRS NHSC 2011 Participant Questionnaire_FINAL
Form 438 HRSA BCRS NHSC 2011 Partner Questionnaire_FINA 438 HRSA BCRS NHSC 2011 Partner Questionnaire_FINAL
444 SSA Call Center Q's FINAL MAY 18 New 3600 420 0 Form 444 Social Security Administration Call Center Que 444 Social Security Administration Call Center Questionnaire FINAL MAY 18
445SAR,446 BSA E-Filing,447FinCEN,448Foreign Case Rep,449 Nut Mgt Q's 2011,450 FAA Carriers Ops Mgt Q's;451 FAA Manuf. Q's;452FAA Qs;453Dep.Ed;454USDA RD Q's RCD Grant RBS;455E-Verif;456USDA R D New 11740 1769 0 Form 445 SAR 5-13-2011 445 SAR 5-13-2011
Form 446 BSA E-Filing 5-12-2011 446 BSA E-Filling 5-12-2011
Form 448 Foreign Case Reports 5-19-2011 448 Foreign Case Reports 5-19-2011
Form 447 FinCEN Domestic Analytic Products 5-19-2011 447 FinCEN Domestic Analytic Products 5-19-2011
Form 449 Nutrient Management Customer Satisfaction Q's 449 Nutrient Management Customer Satisfaction Questionnaire 2011 FINAL
Form 450 FAA Carriers Ops Mgt Questionnaire 2011 Final 450 FAA Carriers Ops Mgt Questionnaire 2011 Final Version
Form 451 FAA Manufacturers Questionnaire 2011 Final Ver 451 FAA Manufacturers Questionnaire 2011 Final Version
Form 452 FAA Repair Station Questionnaire 2011 Final Ve 452 FAA Repair Station Questionnaire 2011 Final Version
Form 453 Dept of ED CFO Grantee Questionnaire CORE + CU 453 Dept of ED CFO Grantee Questionnaire CORE + CUSTOM Final JUN 10 11
Form 454 USDA RD FINAL Questionnaire RCD Grant RBS 454 USDA RD FINAL Questionnaire RCD Grant RBS
Form E-Verification Customer Satisfaction Survey FINAL 455 E-Verification Customer Satisfaction Survey FINAL
Form 456 USDA Rural Development Questionnaire Rural Ele 456 USDA Rural Development Questionnaire Rural Electrification Prog
464 SBA ODA 2011_Final, 465 LBI ACSI Q's FINAL; 466 W&I ACSI Q's FINAL, 467 SBSE ACSI Q's FINAL, 468 DOJ COPS 2011 FINAL Q's; 469 HRSA BPHC Gr. Sur. 2011_Final New 3500 708 0 Form 464 SBA ODA Customer Satisfaction Survey 2011_Fina 464 SBA ODA Customer Satisfaction Survey 2011_Final
Form 465 LBI ACSI Questionnaire FINAL 465 LBI ACSI Questionnaire FINAL
Form 466 W&I ACSI Questionnaire FINAL 466 W&I ACSI Questionnaire FINAL
Form 467 SBSE ACSI Questionnaire FINAL 467 SBSE ACSI Questionnaire FINAL
Form 468 DOJ COPS Annual Survey 2011 FINAL Questionnair 468 DOJ COPS Annual Survey 2011 FINAL Questionnaire
Form 469 HRSA BPHC Grantee Survey 2011_Final 469 HRSA BPHC Grantee Survey 2011_Final
Form 470 Rur Dev 470 Rur Dev Rural Hous and Comm Fac Loans
470 USDA Rural Development Q's; 474 BCA; 475 Asylum - OPS 7 26 2011, 476 NASA CSI Survey 2011 New 6950 1158 0 Form 470 USDA Rural Development Questionnaire Rural Hou 470 USDA Rural Development Questionnaire Rural Housing and Community Facilities Loans FINAL
Form 474 BCA Customer Satisfaction Survey FINAL 474 BCA Customer Satisfaction Survey FINAL
Form 475Asylum Customer Satisfaction Sur.Draft -OPS 7 475 Asylum Customer Satisfaction Survey Draft - OPS 7 26 2011 FINAL
Form 476 NASA CSI Survey 2011_Final 476 NASA CSI Survey 2011_Final
480 US Mint call center Q's 2011 New 2500 125 0 Form 480 US Mint call center Q's 2011 480 US Mint call center Q's 2011
481 RRB and 482 NIST Amb New 500 83 0 Form and Instruction 481 481 RRB
Form and Instruction 482 482 NIST Amb Design
483 AMS MN and 484 GSA Fuel New 500 67 0 Form and Instruction 483 483 AMS MN 2011 Cust Sat Survey
Form and Instruction 484 484 GSA Greenhouse Gas Emissions Pilot
485 HRSA HAB Grantees New 750 188 0 Form and Instruction 485 HRSA HAB 485 HRSA HAB Grantees
Form and Instruction 486 FEMA 486 FEMA Printed BSB Pubs
487 - 489 FinCEN New 750 75 0 Form and Instruction 487 FinCen 487 FinCen compliance mou
Form and Instruction 488 FinCEN 488 FinCEN Reg Res Cntr
Form and Instruction 489 FinCEN 489 FinCEN Secure Outreach Web CBRS
490 - Rec.gov Call Center IVR New 250 17 0 Form and Instruction 490 Rec.go IVR 490 Rec.gov Call Center IVR
492 - 494 PBGC Retirement/Participant and HRSA NELRP/NSP New 1000 200 0 Form and Instruction 494 NELRP and NSP 494 HRSA NELRP and NSP
Form and Instruction 492 492 PBGC Retirement Instrument Survey
Form and Instruction 493 493 PBGC Participant Caller Instrument
495 - 496 DOJ JAG Survey and PBGC Premium Filer New 500 108 0 Form and Instruction 495 DOJ 495 DOJ JAG Questionnaire Final 3-30-12
Form and Instruction 496 PBGC 496 PBGC Premium Filer Questionnaire 2012 Final.doc
497 USCIS IO Questionnaire - 503 Dept of ED CFO Grantee Questionnaire New 5300 1060 0 Form and Instruction 497 2012 497 USCIS IO Questionnaire 2012 FINAL 5-9-12
Form and Instruction 498 2012 498 BSA E-Filing Survey FINAL
Form and Instruction 499 2012 499 FInCEN Domestic Analytic Products Survey FINAL
Form and Instruction 500 2012 500 Foreign Case Reports Survey FINAL
Form and Instruction 501 2012 501 SAR Activity Review Survey FINAL
Form and Instruction 502 2012 502 HRSA BCRS NHSC 2011 Participant Questionnaire FINAL
Form and Instruction 503 2012 503 Dept of ED CFI Grantee Questionnaire CORE + CUSTOM
504 FEMA Questionnaire Local Officials - 505 FEMA Questionnaire Public New 500 100 0 Form and Instruction 504 2012 FEMA Questionnaire Local Officials FINAL DRAFT
Form and Instruction 505 2012 505 FEMA_Questionnaire_Public
506 OCS_ACSI_Survey FINAL 2012.docx - 510 FAA Carriers Ops - Air Carrier Pilots - Final Questionnaire.docx New 1250 250 0 Form and Instruction 506 2012 506 OCS_ACSI_Survey_FINAL 2012.docx
Form and Instruction 507 2012 507 RRB Survivor Survey FINAL 6_13.docx
Form and Instruction 508 2012 508 SBA ODA Customer Satisfaction Survey.docx
Form and Instruction 509 2012 509 FAA Mechanics Customer Satisfaction Survey Final.doc
Form and Instruction 510 2012 510 FAA Carriers Ops - Air Carrier Pilots - Final
511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx New 1250 208 0 Form and Instruction 511 2012 511 LBI ACSI Questionnaire FINAL.docx
Form and Instruction 512 2012 512 SCSE ACSI Questionnaire FINAL.docx
Form and Instruction 513 2012 513 WI ASCI Questionnaire FINAL.doc
Form and Instruction 514 2012 514 Customer Contact Center Survey E-Verify.docx
Form and Instruction 515 2012 515 HRSA BPHC Grantee Survey 7-16-12.docx
516 ACSI General Aviation Survey - 519 NWS Survey Final New 1000 200 0 Form and Instruction 516 516 ACSI General Aviation Survey Final 7-26-12
Form and Instruction 517 517 NASA EOSDIS Questionnaire Final July 23 2012
Form and Instruction 518 518 Annual Outcome Survey Questions Final
Form and Instruction 519 519 NWS Survey Final 8-21-12
520 State BCS ACSI Survey - 521 Forest Service Program Questionnaire New 500 117 0 Form and Instruction 520 State BCS ACSI Survey
Form and Instruction 521 Forest Service R&D Program Questionnaire
CFI 199 - CFI 216: active surveys from previous ICR New 4500 900 0 Form and Instruction CFI 204 PBGC CallSat questionnaire
Form and Instruction CFI 205 TREAS FINCEN SAR Activity Review questionnaire
Form and Instruction CFI 206 TREAS FINCEN Domestic Case Reports questionnaire
Form CFI 207 TREAS FINCEN Proactive Analytic Products questionnaire
Form and Instruction CFI 208 TREAS FINCEN BSA E-Filing questionnaire
Form and Instruction CFI 209 TREAS FINCEN Foreign Investigative Case Reports questionnaire
Form and Instruction CFI 210 FTC CallSat questionnaire
Form and Instruction CFI 211 NRCS FRPP questionnaire
Form and Instruction CFI 212 RRB Retirement Annuity questionnaire
Form and Instruction CFI 213 DHS USCIS Guide CD questionnaire
Form and Instruction CFI 214 DHS USCIS Guide Booklet questionnaire
Form and Instruction CFI 215 DOT FAA ATO questionnaire
Form and Instruction CFI 216 NASA EODIS questionnaire
Form and Instruction CFI 199 DOT FAA Carriers Ops questionnaire
Form and Instruction CFI 200 DOT FAA Air Carrier and Repair Station questionnaire
Form and Instruction CFI 201 DOT FAA Manufacturers qestionnaire
Form and Instruction CFI 202 PBGC Retirees questionnaire
Form and Instruction CFI 203 DOC NOAA NWS CO-OPS questionnaire
CMS Contractor Satisfaction Survey New 250 63 0 Form and Instruction 491 CMS Contractor Satisfaction Survey
Customer Satisfaction Surveys (Individuals and Households) New 3263 653 0 Form and Instruction N/A ACSI Questionnaire for Government Services
Customer Satisfaction Surveys (State, Local and Tribal Governments) New 113 23 0 Form and Instruction N/A ACSI Questionnaire for Government Services
Customer Satistaction Surveys (Private Sector) New 375 75 0 Form and Instruction N/A ACSI Questionnaire for Government Services
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 81671 14034 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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