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

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2125-0628)

TITLE OF INFORMATION COLLECTION:

FHWA Pennsylvania Division Customer Service Survey

PURPOSE:

This collection of information is voluntary and will be used to gauge current business service standards to further the proper performance of the functions of the agency. The results will be used by the Pennsylvania Division Office leadership in striving to become a better business partner.

DESCRIPTION OF RESPONDENTS:

Respondents include experienced State partners (employees with > 3 years experience) in the transportation industry; such as, employees of the Pennsylvania Department of Transportation, Metropolitan and Rural Planning Organizations, and PA Turnpike Commission.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus 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: Moises Marrero

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	No. of Respondents	Participation Time	Burden
State Government	202	15 minutes	50.5
Totals			50.5 hrs

FEDERAL COST: The estimated annual cost to the Federal government is _$0___________

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?

We will select specific respondents based on title within PennDOT Central Office and Districts, MPO/RPO offices and PA Turnpike Commission that will represent the myriad of Federal-aid programs in which our staffs interact.

Administration of the Instrument

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

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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