Forms and Documents

Document Name	Status
Form Survey FSI LTU Language Test Score Feedback Form Form and Instruction	New
Form Survey FSIEX Customer Relationship Survey Form and Instruction	New
Form Survey LTU Language Test Exit Survey Form and Instruction	New
Third Party Contractor (TPC) Workplace Assessment Form	Unchanged
Sanako Student Satisfaction Survey Form and Instruction	Unchanged
Sanako Connect End of Training Survey Form and Instruction	Unchanged
Mobile App User Satisfaction Survey Form and Instruction	Unchanged
Virtual Support Room Satisfaction Survey Form and Instruction	Unchanged
Alpha Beta Survey Form and Instruction	Unchanged
Information Center Annual Patron Needs Survey  Form and Instruction	Unchanged
Online Passport Renewal Survey Form and Instruction	Unchanged
Foreign Aff airs Manual & Handbook Usability Survey Form and Instruction	Unchanged
CSO Diversity and Inclusion Survey Form and Instruction	Unchanged
Survey for Global Guide Form and Instruction	Unchanged
J-1 Summer Work Travel Participants Check-In Form and Instruction	Unchanged
IMET Senior PME Survey Form and Instruction	Unchanged
Personal Safety and Security Questionnaire DS-4183 Submission.docx Supplementary Document	2022-07-01
LTU_Exit_Survey_Follow-up.pdf Supplementary Document	2022-07-01
DS-4183 Generic Clearance Submission LTU Exit Survey 2022.docx Supplementary Document	2022-07-01
DS-4183 Generic Clearance Submission.docx Supplementary Document	2022-07-01
DS-4183 Generic Clearance Submission.docx Supplementary Document	2022-07-01
Online Passport Renewal Survey - Limited Release Users.docx Justification for No Material/Nonsubstantive Change	2021-12-21
Generic Clearance Submission Template.docx Supplementary Document	2020-12-22
Survey Clearance Submission OMB Control Number 1405-0193.docx Supplementary Document	2018-04-17
Clearance Submission Template- Former Consular Fellows.doc Supplementary Document	2018-04-17
Webinars SS.docx Supplementary Document	2018-04-17
Beta Testing SS.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_Foreign Press Center Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs Product Use Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Simulation Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Front End Evaluation Interview Guide.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Exhibit User Tester Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Audience Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Audience Experience with Exhibits .doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_Office of Public Engagement Survey.doc Supplementary Document	2018-04-17
State Kiosk - Generic Clearance Submission Template State Kiosk Survey (6-2015).pdf Supplementary Document	2018-04-17
National Visa Center - Generic Clearance Submission Template (NVC 6-2015).pdf Supplementary Document	2018-04-17
PPT Feedback - Generic Clearance Submission Template PPT Survey (4-2015).pdf Supplementary Document	2018-04-17
Feedback Survey_SV-2016-0002.pdf Supplementary Document	2018-04-17
Generic Clearance Submission DTAG Questionnaire.doc Supplementary Document	2018-04-17
Nonimmigrant Visa - Generica Clearance Submission.pdf Supplementary Document	2018-04-17
ACS - Generic Clearance Submission Template ACS (4-2015) survey.pdf Supplementary Document	2018-04-17
Immigrant Visa - Generic Clearance Submission Template Immigrant Visa Survey (7-2015).pdf Supplementary Document	2018-04-17
Legal Authorities for Customer Service Surveys - Copy.docx Supplementary Document	2020-12-22
Final -Supporting Statement for Generic Clearance.docx Supporting Statement A	2020-12-22
Part B - Supporting Statement for Paperwork Reduction Act Generic Information Collection Submissions for.docx Supporting Statement B	2017-06-27

IC Document Collections

IC ID	Document Title	Status
254464	FSI LTU Language Test Score Feedback Form Form and Instruction	New
254462	FSIEX Customer Relationship Survey Form and Instruction	New
254461	LTU Language Test Exit Survey Form and Instruction	New
252947	Personal Safety & Security Questionnaire Other-Survey	New
252713	Third Party Contractor (TPC) Workplace Assessment Form	Unchanged
250873	Sanako Student Satisfaction Survey Form and Instruction	Unchanged
250872	Sanako Connect End of Training Survey Form and Instruction	Unchanged
250871	Mobile App User Satisfaction Survey Form and Instruction	Unchanged
250870	Virtual Support Room Satisfaction Survey Form and Instruction	Unchanged
250868	Alpha Beta Survey Form and Instruction	Unchanged
250867	Information Center Annual Patron Needs Survey  Form and Instruction	Unchanged
250866	DECCS User Group Other-Focus Group	Unchanged
250629	Online Passport Renewal Survey Form and Instruction	Unchanged
250628	Foreign Aff airs Manual & Handbook Usability Survey Form and Instruction	Unchanged
247932	CSO Diversity and Inclusion Survey Form and Instruction	Unchanged
247470	Survey for Global Guide Form and Instruction	Unchanged
247468	J-1 Summer Work Travel Participants Check-In Form and Instruction	Unchanged
247467	IMET Senior PME Survey Form and Instruction	Unchanged

ICR Details

OMB Control No:	ICR Reference No:
Status:	Previous ICR Reference No:
Agency/Subagency:	Agency Tracking No:
Title:
Type of Information Collection:	Common Form ICR:
Type of Review Request:	Date Received in OIRA:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

	Total	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	0	0	0	0	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion:

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion:

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?

Is this ICR related to the Pandemic Response?

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Common Form ICR: 

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date:

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