Capital Magnet Fund Survey Justification

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1559-0041)

TITLE OF INFORMATION COLLECTION: Capital Magnet Fund Survey

PURPOSE:

As part of the CDFI Fund’s data collection for the Capital Magnet Fund Program (CMF), the CDFI Fund would like to send a brief survey to the CMF awardees (23 awardees) via email. The CDFI Fund plans to create a report highlighting the work completed using the CMF awards. The brief survey (five questions) asks more opinion/general questions rather than seeking specific data. The survey is voluntary and there are no consequences for not completing the survey.

DESCRIPTION OF RESPONDENTS:

Private Sector: The 23 awardees from the Capital Magnet Fund Program.

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: ___Awardees (CMF)

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:________Sandra Kerr________________________________________

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 [ ] 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

Category of Respondent	No. of Respondents	Participation Time	Burden
Awardees	23	10 minutes	3.8 hours
Totals	23	10 minutes	3.8 hours

FEDERAL COST: The estimated annual cost to the Federal government is one-time cost: Minimal for one employee to review the collected information (approximately two hours of work).

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?

Only the 23 awardees from the Capital Magnet Fund will be surveyed.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ X] Other, Explain: Email

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Capital Magnet Fund Awardee Survey Questions

1. What were your sources of leverage (e.g., bank loans, foundation grants, etc.)? Please list all that apply and if possible the percentage used from the different sources of leverage.

2. Did you combine economic development with housing? If so, what types of projects were included? Of the total projects, how many included economic development?

3. If you have used all of your initial Capital Magnet Fund award funding, have you reinvested the funding into other projects? If so, please describe the types of projects.

4. Did you fund projects with Capital Magnet Fund award funding that would not have been possible without the award? In other words, did you use the Capital Magnet Fund award for hard to finance projects?

5. In general, how useful was/is the funding you received from the Capital Magnet Fund?

Quote. The CDFI Fund is also looking for quotes to use in the report being prepared. Please answer the following question or provide any other comment you would like to make (note that we will attribute the quote to you):

How has your Capital Magnet Fund award impacted the community where project(s) have been developed?

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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