signed CEO Statistical Review Clearance Form_EBSA PAP Survey_2020_03_16

U.S. DEPARTMENT OF LABOR
Chief Evaluation Office Concurrence of Surveys Employing Statistical Methods
TO:
Frederick C. Licari, OCIO/OASAM
DATE PREPARED: 3/16/2020
PHONE: 202-693-8073
FROM: Scott Gibbons
PHONE: 202-693-5075
ACTION: Review the attached report proposal, indicate approval or disapproval, and return to the
sponsoring agency or program. Comments shall not be made on the proposed report but in the
comments space below.
TITLE OF SURVEY OR EVALUATION:
EBSA Participant Assistance Program Customer Survey
CLEARANCE:
_X__ Approved

____ Disapproved (see below)

____ Approved with comments (see below)
COMMENTS:
(Insert additional pages as needed)

Disclaimer: CEO is approving only the statistical methodology as presented in the written documentation
and not necessarily passing judgment on the questionnaire itself nor on the necessity of conducting the
collection of information.

SIGNATURE OF REVIEWER

scott gibbons

Digitally signed by scott
gibbons
Date: 2020.03.18 08:42:07
-04'00'