Template USA.gov Beta Site Survey (Req-19)

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 3090-0297)

TITLE OF INFORMATION COLLECTION: Temporary Beta Site Survey for sites on the USA.gov domain (Req-19)

PURPOSE:

To collect feedback about temporary test websites on the USA.gov domain before they become the new official versions. The results of the surveys will be used internally to improve service to the public by informing improvements to the websites before they are launched.

DESCRIPTION OF RESPONDENTS:

Individuals who visit temporary test websites on the USA.gov domain will have the opportunity to complete an optional survey. Participation is voluntary and anonymous. Invitations to view the test sites and participate in the surveys will be extended to subscribers to e-mail lists, visitors to existing USA.gov sites, and other users of USA.gov services. Participants will be both members of the public and government employees.

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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:_David Kaufmann_______________________________________

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 [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] 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
Individuals or households	2,000	3 minutes	100 hrs
Totals	2,000	3 minutes	100 hrs

FEDERAL COST: The estimated annual cost to the federal government is $0. Existing infrastructure resources will be used to implement and maintain the tool.

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?

Only people who directly visit temporary test websites on the USA.gov domain will be invited to take the survey. We will implement a “pop up” survey that will randomly invite visitors to complete the site-wide survey. Invitations to view the test sites and participate in the surveys will be extended to subscribers to e-mail lists, visitors to existing USA.gov sites, and other users of USA.gov services. Participation is voluntary and anonymous.

Based on previous surveys completed, we estimate the number of responses will be no more than 2,000 per year.

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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