Public Assistance Customer Satisfaction Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEMA Form 519-0-1 FEMA Public Assistance Program Customer Satisfaction Survey	Form and Instruction	Modified	Available
FEMA-1874-DR-VA Results Report to UPLOAD.pdf	Supplementary Document	Uploaded 2012-01-19	Available
1660-0107 FEMA NoC Document Narrative of Changes from Last Submission-Tracked Change 10-18-11.docx	Supplementary Document	Uploaded 2012-01-19	Available
60 Day PUBLISHED FRN 1660-0107 10-17-11.pdf	Supplementary Document	Uploaded 2012-01-18	Available
1660-0107 30 Day FRN PUBISHED 1-12-12.pdf	Supplementary Document	Uploaded 2012-01-18	Available
DHS_PTA_Update_20100610_-_Final.docx	Supplementary Document	Uploaded 2011-06-17	Available
1660-0107 Supporting Statement Public Assistance PART B.doc	Supporting Statement B	Uploaded 2012-01-19	Available
OMB Rev. Supporting Statement 1660-0107 Part A 7302012.doc	Supporting Statement A	Uploaded 2012-07-30	Available
Executive Order 12861.doc	Supplementary Document	Uploaded 2008-10-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200830	Public Assistance Customer Satisfaction Survey	Other-Telephone Survey	New
187122	FEMA Public Assistance Program Customer Satisfaction Survey	Other-Focus Group on This Form	Modified
187000	FEMA Public Assistance Program Customer Satisfaction Survey	Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0107	ICR Reference No: 201111-1660-001
Status: Historical Active	Previous ICR Reference No: 201103-1660-001
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Public Assistance Customer Satisfaction Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/30/2012
	Date Received in OIRA: 03/30/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	10,740	0	3,360
Time Burden (Hours)	3,695	0	1,920
Cost Burden (Dollars)	7,344	0	0

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Abstract: This collection of information enables 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 customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs. This feedback will provide insights into customer or stakeholder perceptions, experiences and expectations, provide an early warning of issues with service, or focus attention on areas where communication, training or changes in operations might improve delivery of products or services. These collections will allow for ongoing, collaborative and actionable communications between the Agency and its customers and stakeholders. It will also allow feedback to contribute directly to the improvement of program management.

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Authorizing Statute(s): 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:
	76 FR 64092	10/17/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 1946	01/12/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
FEMA Public Assistance Program Customer Satisfaction Survey	FEMA Form 519-0-1, FEMA Form 519-0-1INT	Public Assistance Customer Satisfaction Survey ,   Public Assistance Customer Satisfaction Survey (Internet)
FEMA Public Assistance Program Customer Satisfaction Survey
Public Assistance Customer Satisfaction Survey

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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	10,740	3,360	0	0	7,380	0
Annual Time Burden (Hours)	3,695	1,920	0	0	1,775	0
Annual Cost Burden (Dollars)	7,344	0	0	7,344	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The adjustment for the three survey formats and focus groups is based on the following: For FEMA Forms 519-0-1T, 519-0-1INT and 519-0-1, there is an increase in the annual hour burden for each form due to an increase in the number and size of declared disasters. Prior collection activity was based on 3,280 respondents per year with a total of 984 annual burden hours. For this collection, a three year average was used based on the total number of applicants who received assistance in disasters declared during FY2008-FY2010; or 10,500 respondents per year. The total burden hour for this collection is 2,975. For FEMA Form 519-0-1T, the current annual hour burden is 700.2 hours; the new hours burden is 1,575 for an increase of 874.8 annual hour burden. For FEMA Form 519-0-1INT, the current annual hour burden is 268.8 hours; the new hours burden is 525 for an increase of 256.2 annual hour burden. For FEMA Form 519-0-1, the current annual hour burden is 15 hours; the new hours burden is 875 for an increase of 860 annual hour burden. For Focus Groups, there is a decrease in the annual burden hours. Prior collection activity estimated 80 participants with an individual burden hour of 11.7 hours. This collection is based on holding 4 sessions in 5 of the 10 FEMA Regions each year with 12 participants at each session for a total of 240 participants who will spend approximately 3 hours each in travel and in attending the session; or a total of 720 burden hours. The current annual hour burden is 936 hours; the new hours' burden is 720 for a decrease of 216 annual hour burden.

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Annual Cost to Federal Government: $843,586

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: 03/30/2012

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