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

ICR 201109-2125-001

OMB: 2125-0628

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
 New
Supplementary Document
2011-09-14
Supporting Statement B
2011-09-14
Supporting Statement A
2011-09-14
IC Document Collections
IC ID
Document
Title
Status
212560 New
212315 New
206434 New
206312 New
204771 New
203918 New
203012 New
200216 New
ICR Details
2125-0628 201109-2125-001
Historical Active
DOT/FHWA
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 10/19/2011
Retrieve Notice of Action (NOA) 09/26/2011
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.
  Inventory as of this Action Requested Previously Approved
10/31/2014 36 Months From Approved
8,900 0 0
3,025 0 0
0 0 0
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.
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
   EO: EO 13571 Name/Subject of EO: Streamlining Service Delivery and Improving Customer Service
  
None
Not associated with rulemaking
  75 FR 80542 12/22/2010
76 FR 174 09/08/2011
No
  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 8,900 0 0 8,900 0 0
Annual Time Burden (Hours) 3,025 0 0 3,025 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Changing Regulations
No
This is a new collection.
$651,500
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Michael Howell 202 366-5262 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/26/2011
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