CS-11-285 - Cover Sheet

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1545-1432)

T ITLE OF INFORMATION COLLECTION:

W&I SPEC Partner Customer Satisfaction Survey

PURPOSE:

The purpose of this contract is to survey SPEC Partners to determine their level of satisfaction with SPEC products and services. Results of this survey determine two SPEC external measures: 1) SPEC Partner Satisfaction; and 2) SPEC Partner Dissatisfaction.

DESCRIPTION OF RESPONDENTS:

The SPEC Partners are organizations such as the United Way that assist taxpayers with the products and services provided by the SPEC organization. Examples of SPEC Partner Types include: Local; National; Outreach; Return Preparation; and, Financial Education.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X ] Other: Web-based Customer Survey

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: /s/ William L Dickie, Policy Analyst/COTR, WIRA Group 7_________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [ X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ X] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

We estimate it will take 2 minutes each to read the pre-notification e-mail, the invitation email and the two reminder e-mails. The survey is expected to take approximately 17 minutes to complete. This estimate is based upon the questionnaire consisting of 59 total questions. However, there are several skip patterns in the survey which limit the questions a respondent sees to only those applicable to their situation. Due to the skip patterns, no single respondent would see more than 43 questions.

Category of Respondent	No. of Respondents	Participation Time	Burden
SPEC Partners Pre-note/Invitation/Reminders	3600	8 min	480.0
SPEC Partners Expected Participants	1200	17 min	340.0
Totals			820.0

Estimated Response Rate: 33%

FEDERAL COST: The estimated annual cost to the Federal government is $136,380.00.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

This is a one-time set of surveys with the goal of reaching a census of all local partners in the SPEC program; therefore, sampling error and confidence do not apply. W&I will provide a list of approximately 3600 local partners. The Contractor will attempt to survey a census all partners.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X] No

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