Information Collection

Customer Service Survey - State, Local, or Tribal Government

IC 183424 under ICR 201702-0579-006 · OMB 0579-0334.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0334 can be found here:

Documents and Forms

Document Name Document Type
Form VS 1-10S (Spanish) Customer Service Survey - State, Local, or Tribal Government Form
Survey Screen Shots 2.docx Other-Web survey
VS 1-10 Customer Service Survey VS 1-10 JUN 2016 AIC1.pdf www.surveymonkey.com/r/VSSurvey2016 Form
VS 1-10S (Spanish) INSPECCION de SERVICIO DE ATENCION AL CLIENTE VS 1-10S JUN 2016 AIC2.pdf www.surveymonkey.com/r/VSSurvey2016 Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Customer Service Survey - State, Local, or Tribal Government	Agency IC Tracking Number:

Is this a Common Form? No		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	VS 1-10S (Spanish)	INSPECCION de SERVICIO DE ATENCION AL CLIENTE	VS 1-10S JUN 2016 AIC2.pdf	http://www.surveymonkey.com/r/VSSurvey2016	Yes	Yes	Fillable Fileable
Other-Web survey			Survey Screen Shots 2.docx		Yes	Yes	Fillable Fileable
Form	VS 1-10	Customer Service Survey	VS 1-10 JUN 2016 AIC1.pdf	http://www.surveymonkey.com/r/VSSurvey2016	Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 33 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,650	1,150	500
Annual IC Time Burden (Hours)	137	95	42
Annual IC Cost Burden (Dollars)	0	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.