WQSA Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2010-0042 can be found here:

Documents and Forms

Document Name Document Type
2434ss76 WQSA Survey.docx Other-Other
2434ss76 WQSA Justification.docx 2434ss76 WQSA Justification IC Document

Information Collection (IC) Details

IC Title:	WQSA Survey	Agency IC Tracking Number:	2434.76

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-Other			2434ss76 WQSA Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 225	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	225	225
Annual IC Time Burden (Hours)	37	37
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2434ss76 WQSA Justification	2434ss76 WQSA Justification.docx	06/28/2017

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