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Member Experience Web Survey
Understanding the Value of Service Survey
OMB: 3045-0147
IC ID: 202505
OMB.report
CNCS
OMB 3045-0147
ICR 201205-3045-002
IC 202505
( )
Documents and Forms
Document Name
Document Type
Form 1
Member Experience Web Survey
Form and Instruction
1 Member Experience Pre-screening questions
FINAL UPE Pre-Screen.docx
www.nationalservice.gov
Form and Instruction
2 Member Experience Survey
CNCS_FINAL WITH Disab UPE Survey_11-13-12.docx
www.nationalservice.gov
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Member Experience Web Survey
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
1
Member Experience Pre-screening questions
FINAL UPE Pre-Screen.docx
www.nationalservice.gov
Yes
Yes
Fillable Fileable
Form and Instruction
2
Member Experience Survey
CNCS_FINAL WITH Disab UPE Survey_11-13-12.docx
www.nationalservice.gov
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
4,000
0
4,000
0
0
0
Annual IC Time Burden (Hours)
1,333
0
1,333
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.