Survey - Section 504 Self-Evaluation Survey

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0788 can be found here:

Documents and Forms

Document Name Document Type
Survey-Sec 504 Self-Eval Survey.doc www.socialsecurity.com. Other-Survey
Template Sec 504 Self-Eval Survey.docx Template - Section 504 Self-Evaluation Survey IC Document

Information Collection (IC) Details

IC Title:	Survey - Section 504 Self-Evaluation Survey	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-Survey			Survey-Sec 504 Self-Eval Survey.doc	www.socialsecurity.com.	Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Template - Section 504 Self-Evaluation Survey	Template Sec 504 Self-Eval Survey.docx	03/09/2012

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