EBSA Participant Assistance Program Customer Survey

DOL Generic Solution for Customer Satisfaction Surveys and Conference Evaluations

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0059 can be found here:

Documents and Forms

Document Name Document Type
US_DOL_EBSA_2015_CE11_Outbound_Revised _Q3_changes.docx Other-Phone Survey
OMB Revised Part A PAP Study 3 30 15.pdf Supplemental Supporting Statement A IC Document
Revised OMB Part B Revision for FY15 Q3 Survey cuts 3-20-15 v2.docx Supplemental Supporting Statement B IC Document

Information Collection (IC) Details

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

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 Agency Discretion
Annual Number of Responses for this IC	11,000	11,000
Annual IC Time Burden (Hours)	1,467	1,467
Annual IC Cost Burden (Dollars)	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.