OMB Survey Digitally Inclusive Comunities

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 3137-0081)
TITLE OF INFORMATION COLLECTION: IMLS Proposed Framework for Digitally
Inclusive Communities
PURPOSE: This survey was designed to capture feedback on the proposed Framework for
Digitally Inclusive Communities and its applicability to address issues in the respondents’
communities and interest areas. Survey data will be used to inform revisions to the proposed
Framework for Digitally Inclusive Communities and plans for its implementation; it will
supplement data being gathered at three community forums (Los Angeles, Oklahoma City, and
Bangor, Maine). Respondents are anticipated to have informed opinions about digital inclusion,
though they may not necessarily be fully familiar with the Framework.

DESCRIPTION OF RESPONDENTS:
Individuals interested in and informed about digital literacy and/or digital inclusion who visit the
IMLS Web page about the proposed Framework for Digitally Inclusive Communities. Their
understanding of the issues involved may vary according to their workplace or the place in which
they access technology and the Internet. We anticipate respondents will represent public or
school libraries; community-based organizations; city/county government; industry; or
community residents.

TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion Group
[ ] Other: ______________________

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:

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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, will any information that is collected be included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ ] No
3. If Yes, has an up-to-date System of Records Notice (SORN) 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
Library (school or public) employee ($27/hr)
Community-based organization employee ($20/hr)
City/county government employee ($49)
K-12 educator ($24/hr)
Industry employee ($32/hr)
Community resident ($0/hr)
Totals

No. of
Respondents
100
100
100
34
33
33
400

Participation
Time
.16 hr
.16 hr
.16 hr
.16 hr
.16 hr
.16 hr

Burden
$432
$320
$784
$130
$168
$0

FEDERAL COST: The estimated annual cost to the Federal government is _$1000.00_____
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?
[ ] Yes [X ] 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?
The survey will be delivered as a pop-up window when people visit the IMLS Web page for the
proposed Framework for Digitally Inclusive Communities. They will be able to accept or decline
participation.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[ X ] Web-based or other forms of Social Media
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[ ] Telephone
[ ] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

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