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-Telephone Survey			US_DOL_EBSA_2016_Q1_CE3_Outbound_2015 10 06 09 57.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

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
OMB Supporting Statement Part A	Revised OMB Part A Revision for FY15 Q3 Survey cuts.docx	12/04/2015
OMB Supporting Statement Part B	OMB Part B.docx	12/04/2015
OCEO Statistical Method Approval	EBSA_Customer Survey Signed Approval.pdf	12/04/2015

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