Evaluation Form for PAESMEM Recognition Event

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3145-0215 can be found here:

Documents and Forms

Document Name Document Type
Evaluation Form_PAESMEM 2015.doc Other-Customer Satisfaction Survey
2015PAESMEMRecognitionEventGenericClearance06032015 (2).docx Supporting Statement for PAESMEM Event IC Document
SPPAESMEM2015RecognitionEventAwardeeGuests06032015.xlsx Attendees IC Document

Information Collection (IC) Details

IC Title:	Evaluation Form for PAESMEM Recognition Event	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-Customer Satisfaction Survey			Evaluation Form_PAESMEM 2015.doc		No		Paper Only

Line of Business: Education

Subfunction: Higher Education

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	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	125	125
Annual IC Time Burden (Hours)	31	31
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement for PAESMEM Event	2015PAESMEMRecognitionEventGenericClearance06032015 (2).docx	06/03/2015
Attendees	SPPAESMEM2015RecognitionEventAwardeeGuests06032015.xlsx	06/03/2015

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