Template 3090-0297 Req-26 CX-COP GCXi customer survey

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

(Req-26)

TITLE OF INFORMATION COLLECTION: CX-COP Customer Survey (GCXi)

PURPOSE:

To collect customer feedback about the Office of Citizen Services and Innovative Technologies’ (OCSIT) Customer Experience Community of Practice (CX-COP.) Results will be used internally to measure program success, improve service to GSA customers, and provide benchmark data for OCSIT’s Government Customer Experience index (GCXi.) This will be the fourth year we’ve run the GCXi. This request is to update survey questions.

DESCRIPTION OF RESPONDENTS:

The CX-COP will survey those of its members who are employees of state and local governments.

Participation is voluntary and anonymous.

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: Rachel Flagg, [email protected], 202.368.0365

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
State, local, or tribal governments	40	6 minutes (.1 hours)	4 hours
Totals	40	6 minutes (.1 hours)	4 hours

FEDERAL COST: The estimated annual cost to the Federal government is $100.

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 members of the CX-COP listserv will be invited to take the survey.

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

[X] Other, Explain – The survey will be distributed via email to members of the CX-COP listserv; responses will be collected via SurveyMonkey. The number of respondents is based on listserv membership.

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

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