Information Collection

Survey Questionnaire

IC 234856 under ICR 201902-0648-001 · OMB 0648-0779.

Documents and Forms

Document Name Document Type
Survey Questionnaire Form and Instruction
Survey Questionnaire Revised survey questionnaire_Dec 13 2018 (002).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Survey Questionnaire	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 and Instruction	NA	Survey Questionnaire	Revised survey questionnaire_Dec 13 2018 (002).pdf		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	50	50
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.