Information Collection

Customer Feedback Kiosk

IC 238266 under ICR 201804-1405-001 · OMB 1405-0193.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0193 can be found here:

Documents and Forms

Document Name Document Type
Kiosk Survey.pdf Other-Kiosk Survey
DS-4183.pdf Generic Clearance Submission - CA Kiosk IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Customer Feedback Kiosk	Agency IC Tracking Number:

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
Other-Kiosk Survey			Kiosk Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 650,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	650,000	650,000
Annual IC Time Burden (Hours)	1,806	1,806
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Submission - CA Kiosk	DS-4183.pdf	10/24/2019

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