2021 Outreach Evaluation Form

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⚠️ Notice: This information collection may be referencing outdated material.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 1557-0248 can be found here:

Documents and Forms

Document Name Document Type
2021 Outreach Evaluation Form Form
2021 Outreach Evaluation Form Proposed OCC Outreach Form 081821 with Future Events DropDown.docx Form
2021 Outreach Evaluation Form Proposed OCC Outreach Form 081821 with Future Events DropDown.docx Form
OMB Justification - 2021 Outreach Evaluation Form 8-18-21.docx Justification for Non Material Change IC Document
OMB Justification - 2021 Outreach Evaluation Form 8-18-21.docx Justification for Non Material Change IC Document

Information Collection (IC) Details

IC Title:	2021 Outreach Evaluation Form	Agency IC Tracking Number:

IC Status: Modified

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	N/A	2021 Outreach Evaluation Form	Proposed OCC Outreach Form 081821 with Future Events DropDown.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	501	501
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification for Non Material Change	OMB Justification - 2021 Outreach Evaluation Form 8-18-21.docx	08/18/2021

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