Information Collection

OMBudsman Survey

IC 214956 under ICR 201408-0651-003 · OMB 0651-0078.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0078 can be found here:

Documents and Forms

Document Name Document Type
Ombudsman Survey Form
Ombudsman Survey 2015 Ombudsman Survey instrument.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Ombudsman Survey	Agency IC Tracking Number:

Is this a Common Form? No		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	none	Ombudsman Survey	2015 Ombudsman Survey instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,100	1,100
Annual IC Time Burden (Hours)	92	92
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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