Evaluation of Roster Program (Roster Member) - IC for Private Sector Respondents

Program Evaluation Instruments - Roster Program Services (Two Instruments)

Documents and Forms

Document Name Document Type
Form 3320-0005(2) Evaluation of Roster Program (Roster Member) - IC for Private Sector Respondents Form and Instruction
3320-0005(2) Roster Services - Member Questionnaire (Rev 2012) Roster Services Member Questionnaire _Rev 2012.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Evaluation of Roster Program (Roster Member) - IC for Private Sector Respondents	Agency IC Tracking Number:	0005 RMs

Is this a Common Form? No		IC Status: Modified

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	3320-0005(2)	Roster Services - Member Questionnaire (Rev 2012)	Roster Services Member Questionnaire _Rev 2012.pdf		Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 240	Number of Respondents for Small Entity: 120

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	240	-40	280
Annual IC Time Burden (Hours)	12	-7	19
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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