DSIMB Helpdesk Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Renewal)

Documents and Forms

Document Name Document Type
Form 5800-010 DSIMB Helpdesk Survey Form
5800-010 DSIMB Helpdesk Survey Questions DSIMB Helpdesk Survey Questions.docx Form
5800-010 DSIMB Helpdesk Survey Questions DSIMB Helpdesk Survey Questions.docx Form
Justification_DSIMB Helpdesk Survey .docx Justification IC Document
Justification_DSIMB Helpdesk Survey .docx Justification IC Document

Information Collection (IC) Details

IC Title:	DSIMB Helpdesk Survey	Agency IC Tracking Number:	2434.238

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	5800-010	DSIMB Helpdesk Survey Questions	DSIMB Helpdesk Survey Questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Remediation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification	Justification_DSIMB Helpdesk Survey .docx	05/30/2024

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