Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form MCSA-5884 FMCSA HHG Customer Knowledge and Satisfaction Online Study Questionnaire	Form	New	Available
Form MCSA-5886 Motorcoach Traveler Customer Satisfaction Survey	Form	New	Available
Form MCSA-5883 Motorcoach Passenger Survey: Motorcoach Traveler Customer Satisfaction	Form	New	Available
Form MCSA-5884 FMCSA HHG Customer Knowledge and Satisfaction Phone Study Questionnaire	Form and Instruction	New	Available
Form MCSA-5871 2012 FMCSA/TRB Annual Forum Evaluation Form	Form	New	Available
Form MCSA-5870 2012 TRB ART Forum Topic Selection Questionnaire	Form and Instruction	New	Available
PRA-2126NEW.Generic_Clearance.SS.PartA.072611.USE[1]_final.doc	Supporting Statement A	Uploaded 2011-09-06	Available
PRA-2126New.Generic Clearance.SubmissionTemplate.doc	Supplementary Document	Uploaded 2011-07-26	Available
PRA-2126NEW.Generic Clearance.SS.PartB.Use.072611.doc	Supporting Statement B	Uploaded 2011-07-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212125	Movement of Household Goods: Customer Satisfaction Questionnaire	Form	New	FMCSA HHG Customer Knowledge and Satisfaction Online Study Questionnaire
209508	Motorcoach Traveler Satisfaction In-Depth Interview Questionnaire	Form	New	Motorcoach Traveler Customer Satisfaction Survey
207803	Motorcoach Travelers Satisfaction Questionnaire	Form	New	Motorcoach Passenger Survey: Motorcoach Traveler Customer Satisfaction
207299	Movement of Household Goods: Customer Satisfaction Questionnaire	Form and Instruction	New	FMCSA HHG Customer Knowledge and Satisfaction Phone Study Questionnaire
200516	Generic Clearance for the Collection of Routine Customer Feedback	Form	New	2012 FMCSA/TRB Annual Forum Evaluation Form
199699	Customer Satisfaction (products and services) 2012 TRB ART Forum Topic Selection Questionnaire	Form and Instruction	New	2012 TRB ART Forum Topic Selection Questionnaire

ICR Details

OMB Control No: 2126-0049	ICR Reference No: 201107-2126-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOT/FMCSA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
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: 09/07/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/28/2011
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.”

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved
Responses	51,300	0	0
Time Burden (Hours)	10,350	0	0
Cost Burden (Dollars)	1,320	0	0

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): EO: EO 13571 Name/Subject of EO: Streamlining Service Delivery and Improving Customer Service
   EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

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 80542	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 12212	03/04/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Customer Satisfaction (products and services) 2012 TRB ART Forum Topic Selection Questionnaire	MCSA-5870	2012 TRB ART Forum Topic Selection Questionnaire
Generic Clearance for the Collection of Routine Customer Feedback	MCSA-5871	2012 FMCSA/TRB Annual Forum Evaluation Form
Motorcoach Traveler Satisfaction In-Depth Interview Questionnaire	MCSA-5886	Motorcoach Traveler Customer Satisfaction Survey
Motorcoach Travelers Satisfaction Questionnaire	MCSA-5883	Motorcoach Passenger Survey: Motorcoach Traveler Customer Satisfaction
Movement of Household Goods: Customer Satisfaction Questionnaire	MCSA-5884	FMCSA HHG Customer Knowledge and Satisfaction Online Study Questionnaire
Movement of Household Goods: Customer Satisfaction Questionnaire	MCSA-5884	FMCSA HHG Customer Knowledge and Satisfaction Phone Study Questionnaire

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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	51,300	0	0	51,300	0	0
Annual Time Burden (Hours)	10,350	0	0	10,350	0	0
Annual Cost Burden (Dollars)	1,320	0	0	1,320	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This program change increase in total time burden hours of 10,350 over three years is due to a new generic ICR.

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Annual Cost to Federal Government: $602,400

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]? No

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: 07/28/2011

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