EBSA Participant Assistance Program Customer Survey

ICR 202109-1210-001

OMB: 1210-0161

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2021-09-30
Supplementary Document
2021-09-30
Supplementary Document
2021-09-30
Supplementary Document
2021-09-30
Supplementary Document
2021-09-29
Supplementary Document
2021-09-29
Supporting Statement B
2021-09-20
Supporting Statement A
2021-09-29
IC Document Collections
ICR Details
1210-0161 202109-1210-001
Received in OIRA 201912-1210-001
DOL/EBSA
EBSA Participant Assistance Program Customer Survey
Revision of a currently approved collection   No
Regular 09/30/2021
  Requested Previously Approved
36 Months From Approved 06/30/2023
11,200 11,200
1,867 1,493
0 0

The purpose of this data collection effort is to solicit inquirers’ feedback and compile reports on the applicability and utility of EBSA’s Participant Assistance Program. This survey will collect customer satisfaction data for a sample of private citizens who call into the participant assistance program to ask about their private sector employer provided benefits such as pensions, retirement savings, and health benefits.

None
EO: EO 13985 Name/Subject of EO: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government

Not associated with rulemaking

  86 FR 38500 07/21/2021
86 FR 54245 09/30/2021
No

1
IC Title Form No. Form Name
EBSA Participant Assistance Program Customer Survey

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 11,200 11,200 0 0 0 0
Annual Time Burden (Hours) 1,867 1,493 374 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The survey’s demographic questions have been updated in response to Executive Order 13985—Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. Each survey should take approximately an additional two minutes to complete.

$696,085
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
James Butikofer 202 693-8434 Butikofer.James@dol.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/30/2021


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