American Customer Satisfaction Index "Customer Satisfaction Surveys"

Forms and Documents

Document Name	Status
Form 520 520 State BCS ACSI Survey - 521 Forest Service Program Questionnaire Form and Instruction	New
Form 516 516 ACSI General Aviation Survey - 519 NWS Survey Final Form and Instruction	New
Form 511 511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx Form and Instruction	New
Form 509 506 OCS_ACSI_Survey FINAL 2012.docx - 510 FAA Carriers Ops - Air Carrier Pilots - Final Questionnaire.docx Form and Instruction	New
Form 504 504 FEMA Questionnaire Local Officials - 505 FEMA Questionnaire Public Form and Instruction	New
Form 497 497 USCIS IO Questionnaire - 503 Dept of ED CFO Grantee Questionnaire Form and Instruction	New
Form 495 DOJ 495 - 496 DOJ JAG Survey and PBGC Premium Filer Form and Instruction	New
Form 494 NELRP and NSP 492 - 494 PBGC Retirement/Participant and HRSA NELRP/NSP Form and Instruction	New
Form 491 CMS Contractor Satisfaction Survey Form and Instruction	New
Form 490 Rec.go IVR 490 - Rec.gov Call Center IVR Form and Instruction	New
Form 487 FinCen 487 - 489 FinCEN Form and Instruction	New
Form 485 HRSA HAB 485 HRSA HAB Grantees Form and Instruction	New
Form 483 483 AMS MN and 484 GSA Fuel Form and Instruction	New
Form 480 US Mint call c 480 US Mint call center Q's 2011 Form	New
Form 477 NIST Ambulance 2011 477 NIST Ambulance Design FINAL Form	New
Form 470 USDA Rural Dev 470 USDA Rural Development Q's; 474 BCA; 475 Asylum - OPS 7 26 2011, 476 NASA CSI Survey 2011 Form	New
Form 464 SBA ODA Custom 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 Form	New
Form 481 481 RRB and 482 NIST Amb Form and Instruction	New
Form 445 SAR 5-13-2011 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 Form	New
Form 444 Social Securit 444 SSA Call Center Q's FINAL MAY 18 Form	New
Form 434 FEMA_Questionn 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 Form	New
Form 428 PBGC Premium F 428 PBGC Premium Filer Q's 2011 F, 429 VBA 2011 Insurance Claims Q's F, 430 VBA 2011 Call Center Q's F Form	New
Form 423 DOJ COPS Publi 423 DOJ COPS Publication MonthlySurvey FY2011 UPDATED 3_18 Form	New
Form 409 VHA ChampVA 20 409 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 Form	New
Form 403 Customer Satis 403 Customer Satisfaction Questionnaire.docx Form	New
Form 397 FinCEN Complia 397 FinCEN Compliance MOU Customer Survey 2011_draft, 402 ACSI Annual Customer Satisfaction Survey FINAL Form	New
Form 2011 395 Regulator 395 Regulatory Resource Center Customer Survey 2011_FINAL, 396 FinCEN Secure Outreach_WebCBRS Survey 2011_FINAL Form	New
Form 388 Dept of Labor 388 Dept of Labor EBSA Q's FINAL 389 Tricare survey Outpatient 390 Tricare survey Inpatient Form	New
Form 379 IRS LB & I Que 379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final Form	New
Form 375 DTIC 374 - 376 IRS DTIC AFI Form and Instruction	New
Form 367 NCA Customer S 367 NCA , 368 FCIC Q's 2010 Form	New
Form 351 final NCES Que 351-361 NCES_ Passport Q's_ EEOC_ IRS Small and Self Employed Filers_ODA_ LSA_Senior Corps Form	New
Form 348 CPSC.gov Quest 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 Form	New
Form 342 SEC OIEA Jul 2 342 SEC OIEA Jul 2010 Questionnaire Call Center Questionnaire Form	New
Form 335 2010 State and 335 State and Local Q's 336, 337 HRSA BCRS NHSC 338 FinCen Form	New
Form 326 RPPD 6-11-2010 325 TSSD 6-2-2010 326 RPPD 6-11-2010 327 IPD 5-27-2010 328NASA Form	New
Form 319 FEMA QS and Lo 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 Form	New
Form 2010 307 FAA Gen A 307 FAA Pilots 308 Carrier Ops 309 Mechanics Form	New
Form 303 PBGC Participa 303 PBGC Participant Caller 304 PBGC Retiree Caller Form and Instruction	New
Form 298 MCHB 298 MCHB Form and Instruction	New
Form 294 FAA OoA 294 FAA Ofc of Airports, 295 FinCEN Secure Outreach, 296 FinCEN Compliance, 297 FinCEN Regulatory Form	New
Form 288 CFI 288 VHA Outpatient 289 VHA Inpatient 290 Rural Dev Form	New
Form 284 CFI 284 CFI US Mint Treasury Form	New
Form CFI 204 CFI 199 - CFI 216: active surveys from previous ICR Form and Instruction	New
Customer Satisfaction Surveys (State, Local and Tribal Governments) Form and Instruction	New
Customer Satistaction Surveys (Private Sector) Form and Instruction	New
Customer Satisfaction Surveys (Individuals and Households) Form and Instruction	New
SS for 1090-0007 Part A 8.14.09.pdf Supporting Statement A	2009-08-19
FR 30 Day Notice Published 8.18.09.pdf Supplementary Document	2009-08-18
SS for 1090-0007 Part B 8.14.09.pdf Supporting Statement B	2009-08-14
CFI_ACSI Methodology.pdf Supplementary Document	2009-08-14
ACSI Methodology Paper.pdf Supplementary Document	2009-08-13
CTA Comparison for OMB.pdf Supplementary Document	2009-08-10
E.O. 12,862.htm Supplementary Document	2009-08-05
E.O. 13,450.pdf Supplementary Document	2009-08-05
Government Performance Results Act of 1993.pdf Supplementary Document	2009-08-05
FR 60 Notice Published 5.15.09.pdf Supplementary Document	2009-08-05

IC Document Collections

IC ID	Document Title	Status
203946	520 State BCS ACSI Survey - 521 Forest Service Program Questionnaire Form and Instruction	New
203749	516 ACSI General Aviation Survey - 519 NWS Survey Final Form and Instruction	New
203404	511 LBI ACSI Questionnaire FINAL.docx - 515 HRSA BPHC Grantee Survey 7-16-12.docx Form and Instruction	New
202874	506 OCS_ACSI_Survey FINAL 2012.docx - 510 FAA Carriers Ops - Air Carrier Pilots - Final Questionnaire.docx Form and Instruction	New
202512	504 FEMA Questionnaire Local Officials - 505 FEMA Questionnaire Public Form and Instruction	New
202250	497 USCIS IO Questionnaire - 503 Dept of ED CFO Grantee Questionnaire Form and Instruction	New
201756	495 - 496 DOJ JAG Survey and PBGC Premium Filer Form and Instruction	New
201548	492 - 494 PBGC Retirement/Participant and HRSA NELRP/NSP Form and Instruction	New
201482	CMS Contractor Satisfaction Survey Form and Instruction	New
201024	490 - Rec.gov Call Center IVR Form and Instruction	New
200986	487 - 489 FinCEN Form and Instruction	New
200886	485 HRSA HAB Grantees Form and Instruction	New
200284	483 AMS MN and 484 GSA Fuel Form and Instruction	New
199147	480 US Mint call center Q's 2011 Form	New
198907	2011 477 NIST Ambulance Design FINAL Form	New
198663	470 USDA Rural Development Q's; 474 BCA; 475 Asylum - OPS 7 26 2011, 476 NASA CSI Survey 2011 Form	New
198463	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 Form	New
198462	481 RRB and 482 NIST Amb Form and Instruction	New
198024	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 Form	New
197855	444 SSA Call Center Q's FINAL MAY 18 Form	New
197563	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 Form	New
197228	428 PBGC Premium Filer Q's 2011 F, 429 VBA 2011 Insurance Claims Q's F, 430 VBA 2011 Call Center Q's F Form	New
197069	423 DOJ COPS Publication MonthlySurvey FY2011 UPDATED 3_18 Form	New
196721	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 Form	New
196152	403 Customer Satisfaction Questionnaire.docx Form	New
196041	397 FinCEN Compliance MOU Customer Survey 2011_draft, 402 ACSI Annual Customer Satisfaction Survey FINAL Form	New
195916	395 Regulatory Resource Center Customer Survey 2011_FINAL, 396 FinCEN Secure Outreach_WebCBRS Survey 2011_FINAL Form	New
195573	388 Dept of Labor EBSA Q's FINAL 389 Tricare survey Outpatient 390 Tricare survey Inpatient Form	New
195191	379 IRS LB & I Q's, 380 VHAInpatient_Survey_10_Final, 381 VHAOutpatient_Survey_10_Final Form	New
194890	374 - 376 IRS DTIC AFI Form and Instruction	New
194780	367 NCA , 368 FCIC Q's 2010 Form	New
194569	351-361 NCES_ Passport Q's_ EEOC_ IRS Small and Self Employed Filers_ODA_ LSA_Senior Corps Form	New
194414	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 Form	New
194130	342 SEC OIEA Jul 2010 Questionnaire Call Center Questionnaire Form	New
193840	335 State and Local Q's 336, 337 HRSA BCRS NHSC 338 FinCen Form	New
193329	325 TSSD 6-2-2010 326 RPPD 6-11-2010 327 IPD 5-27-2010 328NASA Form	New
193128	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 Form	New
192472	307 FAA Pilots 308 Carrier Ops 309 Mechanics Form	New
192185	303 PBGC Participant Caller 304 PBGC Retiree Caller Form and Instruction	New
191991	298 MCHB Form and Instruction	New
191832	294 FAA Ofc of Airports, 295 FinCEN Secure Outreach, 296 FinCEN Compliance, 297 FinCEN Regulatory Form	New
191711	288 VHA Outpatient 289 VHA Inpatient 290 Rural Dev Form	New
191314	284 CFI US Mint Treasury Form	New
190292	CFI 199 - CFI 216: active surveys from previous ICR Form and Instruction	New
190178	Customer Satisfaction Surveys (State, Local and Tribal Governments) Form and Instruction	New
190177	Customer Satistaction Surveys (Private Sector) Form and Instruction	New
190176	Customer Satisfaction Surveys (Individuals and Households) Form and Instruction	New

ICR Details

OMB Control No: 1090-0007	ICR Reference No: 200908-1090-001
Status: Historical Active	Previous ICR Reference No: 200904-1090-001
Agency/Subagency: DOI/ASPMB	Agency Tracking No:
Title: American Customer Satisfaction Index "Customer Satisfaction Surveys"
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/15/2009
	Date Received in OIRA: 08/19/2009
Terms of Clearance: This survey should be reviewed against any new statistical standards in light of new web technologies being utilized by Federal agencies the next time it comes in for extension or revision.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2012	36 Months From Approved	10/31/2009
Responses	112,500	0	117,000
Time Burden (Hours)	22,500	0	23,400
Cost Burden (Dollars)	0	0	0

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Abstract: The objectives of surveying citizen users of Federal Agencies as part of the American Customer Satisfaction Index are: (1) to make the agencies part of a national measure of customer satisfaction; (2) to benchmark against other agencies and companies; and (3) to provide information for improving customer satisfaction.

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Authorizing Statute(s): US Code: 31 USC 1116 Name of Law: Government Performance Results Act
   EO: EO 13450 Name/Subject of EO: Improving Government Program Performance
   EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 22954	05/15/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 41737	08/18/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 47

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

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	112,500	117,000	0	0	-4,500	0
Annual Time Burden (Hours)	22,500	23,400	0	0	-900	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is an adjustment downward in the total 3-year burden projected from the previous 3-year burden due to a decrease in the number of responses now required to consider a survey "completed".

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Annual Cost to Federal Government: $562,427

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/19/2009

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