One-Week Post-Satisfaction Survey

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⚠️ Notice: This information collection may be referencing outdated material.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 1103-0117 can be found here:

Documents and Forms

Document Name Document Type
Form 1103-0117 One-Week Post-Satisfaction Survey Form and Instruction
1103-0117 One-Week Post Satisfaction Survey TA Applicant One Week Post-TA Impact Survey GEN IC 1103-0117.docx Form and Instruction
Generic Clearance Submission Template - 04012019-COPS Survey Instrument .docx One-Week Post-Satisfaction Survey IC Document

Information Collection (IC) Details

IC Title:	One-Week Post-Satisfaction Survey	Agency IC Tracking Number:	1103-0117

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	1103-0117	One-Week Post Satisfaction Survey	TA Applicant One Week Post-TA Impact Survey GEN IC 1103-0117.docx		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
One-Week Post-Satisfaction Survey	Generic Clearance Submission Template - 04012019-COPS Survey Instrument .docx	04/02/2019

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