Generic Clearance for Customer Surveys for Stakeholders/Partners and State and Local Government

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
10608	Generic Clearance for Customer Surveys for Stakeholders/Partners and State and Local Government		Migrated

ICR Details

OMB Control No: 1004-0193	ICR Reference No: 200007-1004-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOI/BLM	Agency Tracking No:
Title: Generic Clearance for Customer Surveys for Stakeholders/Partners and State and Local Government
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/24/2000
	Date Received in OIRA: 07/06/2000
Terms of Clearance: This programmatic clearance is approved under the following terms of clearance. Prior to the use of each instrument, the agency must complete the form used to submit survey instruments u nder 1004-0181, answer the folowing supplemental questions and provide this package to OIRA for review. 1. Explain who will be conducting this survey. What program office will be conducting the survey? What services does this program provide? Who are the customers? How are these services provided to the customer? 2. Explain how this survey was developed. With whom did you consult during the development of this survey on content? statistics? What suggestions did you get about improving the survey? 3. Explain how the survey will be conducted. How will the customers be sampled (if fewer than all customers will be surveyed)? What percentage of customers asked to take the survey will respond? What actions are planned to increase the response rate? (Web-based surveys are not an acceptable method of sampli ng a broad population. Web-based surveys must be limited to serv ices provided by the Web.) 4. Describe how the results of this survey will be analyzed and used. If the customer population is sampled, what statistical te chniques will be used to generalize to results to the entire cust omer population? Is this survey intended to measure a GPRA perfo rmance measure? (If so, please include an excerpt from the appro priate document). The subagency program official must sign the f orm and send the survey instrument, form, and answers to the supp lemental questions to the OIRA docket. OIRA will review the inst rument for no more than 2 weeks and inform the paperwork clearanc e officer by email when review has been completed, after which the paperwork officer may use OMB control number 1004-0193 on the instrument.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2003	08/31/2003
Responses	1,720	0	0
Time Burden (Hours)	430	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The BLM proposed to use a new information collection for determining the satisfaction of its customers with its program and services. A currently approved collection (1004-0181) covered all survey instruments, both customer comment cards and telephone surveys, and the use of focus groups to determine what questions to ask and comments to solicit. The new collection will concern only customers surveys specific programs. The anticipated programs/customers for survey are: State and Local Governments and Stakeholders and Partners.

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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? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Generic Clearance for Customer Surveys for Stakeholders/Partners and State and Local Government

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	1,720	0	0	1,720	0	0
Annual Time Burden (Hours)	430	0	0	430	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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

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

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 07/06/2000

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