Voluntary Industry Partner Surveys to Implement E.O. 12862

Forms and Documents

Document Name	Status
Form 0990-0220 Vendor Form	New
0990-0220.doc Supporting Statement B	2010-06-10
0990-220 Updated Supporting Statement 2010 06 28(3).doc Supporting Statement A	2010-06-30

IC Document Collections

IC ID	Document Title	Status
193516	Grant Recipients Other-questionnaire	New
193515	Vendor Form	New

ICR Details

OMB Control No: 0990-0220	ICR Reference No: 201006-0990-003
Status: Historical Active	Previous ICR Reference No: 200704-0990-002
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Voluntary Industry Partner Surveys to Implement E.O. 12862
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/30/2010
	Date Received in OIRA: 06/30/2010
Terms of Clearance: Previous terms remain in effect.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2013	36 Months From Approved	07/31/2010
Responses	2,667	0	2,133
Time Burden (Hours)	478	0	382
Cost Burden (Dollars)	0	0	0

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Abstract: DHHS will survey its partners and stakeholders to learn how they feel about departmental services. The information will be used to identify ways to improve the efficiency, quality, timeliness, and cost effective ways to provide services to the Surveys of customer satisfaction with the grants and contract processes for DHHS, to provide information for the balanced scorecard, GPRA, and other management purposes and to make improvements. Respondents are expected to be grant recipients and vendors.

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Authorizing Statute(s): US Code: 5 USC 305b Name of Law: EO
   EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
   EO: EO 12862 Name/Subject of EO: Voluntary Academic and Industry Partner Surveys
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 13287	03/19/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 37808	06/30/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Grant Recipients
Vendor	0990-0220	Partner survey

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ICR Summary 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	2,667	2,133	0	0	534	0
Annual Time Burden (Hours)	478	382	0	0	96	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

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: $5,000

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]? No

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)? No

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: 06/30/2010

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