View Information Collection (IC)

View Information Collection (IC)

IC Title:	EBSA Participant Assistance Program Customer Survey	Agency IC Tracking Number:

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
Other-Phone Survey			US_DOL_EBSA_2015_CE11_Outbound_Revised _Q3_changes.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	11,000	0	11,000	0	0	0
Annual IC Time Burden (Hours)	1,467	0	1,467	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supplemental Supporting Statement A	OMB Revised Part A PAP Study 3 30 15.pdf	03/31/2015
Supplemental Supporting Statement B	Revised OMB Part B Revision for FY15 Q3 Survey cuts 3-20-15 v2.docx	03/31/2015

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