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⚠️ Notice: This information collection may be referencing outdated material.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 2125-0628 can be found here:

Documents and Forms

Document Name Document Type
ADA Customer Satisfaction Feedback 2021 0422.docx Other-Online Feedback
ADA Fast Track Form HCR 2021 0414 (003).docx CUSTOMER SATISFACTION FEEDBACK FOR STATE ADA TRANSITION PLAN IMPLEMENTATION IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Agency IC Tracking Number:

IC Status: Unchanged

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-Online Feedback			ADA Customer Satisfaction Feedback 2021 0422.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	53	53
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CUSTOMER SATISFACTION FEEDBACK FOR STATE ADA TRANSITION PLAN IMPLEMENTATION	ADA Fast Track Form HCR 2021 0414 (003).docx	04/23/2021

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