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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 Survey	Form and Instruction	New	Available
Form 1 Survey Screenshots	Form and Instruction	New	Available
Form 1 Survey Screenshots (Data Submitters)	Form and Instruction	New	Repair queued
Form 1 Survey Screenshots (Data Users)	Form and Instruction	New	Available
Form 1 Feedback survey	Form and Instruction	New	Available
Form 1 Key Informant Interview Questions	Form and Instruction	New	Available
Form 1 Taipei Survey	Form and Instruction	New	Available
Form 1 T32 PI Survey Instrument	Form	New	Available
Form 1 Attachment 1 DAIDS cQMP	Form and Instruction	New	Available
Form 3 Telephone interview survey	Form and Instruction	New	Available
Form 2 Paper Interview Survey	Form and Instruction	New	Available
Form 1 Telephone follow up script SCREENER	Form and Instruction	New	Available
Form 4 Online Survey	Form and Instruction	New	Available
Form 1 Online customer satisfaction survey screen shots	Form and Instruction	New	Available
Form 2 OGR US-GA Program Development Workshop	Form and Instruction	New	Available
Form 1 OGR MENA Workshop	Form and Instruction	New	Available
Form 1 BTCG Survey	Form and Instruction	New	Available
Form 1 Grantee Survey	Form and Instruction	New	Available
Form 1 User Feedback on NIAID's (ICRRM)	Form and Instruction	New	Available
Form 1 User Feedback ICRRM).	Form and Instruction	New	Available
Final Fast Track_SS B_generic_qualitative_feedback_NIAID with PCB comments NIAID Final_GMA.doc	Supporting Statement B	Uploaded 2012-11-26	Available
Generic_Clearance_Submission_Template1 (2)[1].doc	Supplementary Document	Uploaded 2012-11-26	Available
Final Fast Track_SS A _generic_qualitative_feedback_NIAID with PCB comments NIAID Final_Minus Section B.doc	Supporting Statement A	Uploaded 2012-11-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217622	The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	Form and Instruction	New	Survey
217622	The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	Form and Instruction	New	Survey Screenshots
217153	The Immunology Database and Analysis Portal (ImmPort) System Customer Satisfaction Surveys	Form and Instruction	New	Survey Screenshots (Data Submitters)
217153	The Immunology Database and Analysis Portal (ImmPort) System Customer Satisfaction Surveys	Form and Instruction	New	Survey Screenshots (Data Users)
216771	The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	Form and Instruction	New	Feedback survey
214870	NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) Network Pandemic Influenza Research Response Planning Customer Feedback Interviews	Form and Instruction	New	Key Informant Interview Questions
214363	Office of Global Research (OGR) U.S.-Japan Cooperative Medical Sciences Program (CMSP), 17th International Conference on Emerging Infectious Diseases (EID)	Form and Instruction	New	Taipei Survey
213986	Customer Satisfaction Survey on NIAID's Institutional Research Training Grant (T32) program	Form	New	T32 PI Survey Instrument
213234	Assessment of the DAIDS Clinical Quality Assurance Program	Form and Instruction	New	Attachment 1 DAIDS cQMP
212835	Assessment of the NIAID Supported Partnerships Program	Form and Instruction	New	Telephone interview survey
212835	Assessment of the NIAID Supported Partnerships Program	Form and Instruction	New	Paper Interview Survey
212835	Assessment of the NIAID Supported Partnerships Program	Form and Instruction	New	Telephone follow up script SCREENER
212835	Assessment of the NIAID Supported Partnerships Program	Form and Instruction	New	Online Survey
211958	Online customer satisfaction survey for collecting feedback on NIH/NIAID grants-related knowledge management needs and resources	Form and Instruction	New	Online customer satisfaction survey screen shots
211491	Office of Global Research (OGR) Georgia and MENA Workshops	Form and Instruction	New	OGR US-GA Program Development Workshop
211491	Office of Global Research (OGR) Georgia and MENA Workshops	Form and Instruction	New	OGR MENA Workshop
209146	Evaluation Form for the Bridging the Career Gap for Underrepresented Minority Scientists workshop	Form and Instruction	New	BTCG Survey
208419	Grantees' Perceptions Regarding the NIAID DAIDS Phased Innovation Award (R21/R33) Funding Mechanism	Form and Instruction	New	Grantee Survey
207354	User Feedback on NIAID's International Clinical Research Regulatory Matrix (ICRRM)	Form and Instruction	New	User Feedback on NIAID's (ICRRM)
207263	User Feedback on NIAID's International Clinical Research Regulatory Matrix (ICRRM).	Form and Instruction	New	User Feedback ICRRM).

ICR Details

OMB Control No: 0925-0668	ICR Reference No: 201212-0925-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIAID)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/14/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/12/2012
Terms of Clearance: 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.¿

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2016	36 Months From Approved
Responses	28,000	0	0
Time Burden (Hours)	48,300	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable NIAID 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.

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Authorizing Statute(s): None

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:
	75 FR 80542	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 72361	12/05/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 14

table that charts list of burden

IC Title	Form No.	Form Name
Assessment of the DAIDS Clinical Quality Assurance Program	1	Attachment 1 DAIDS cQMP
Assessment of the NIAID Supported Partnerships Program	4, 1, 3, 2	Telephone follow up script SCREENER ,   Paper Interview Survey ,   Telephone interview survey ,   Online Survey
Customer Satisfaction Survey on NIAID's Institutional Research Training Grant (T32) program	1	T32 PI Survey Instrument
Evaluation Form for the Bridging the Career Gap for Underrepresented Minority Scientists workshop	1	BTCG Survey
Grantees' Perceptions Regarding the NIAID DAIDS Phased Innovation Award (R21/R33) Funding Mechanism	1	Grantee Survey
NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) Network Pandemic Influenza Research Response Planning Customer Feedback Interviews	1	Key Informant Interview Questions
Office of Global Research (OGR) Georgia and MENA Workshops	1, 2	OGR MENA Workshop ,   OGR US-GA Program Development Workshop
Office of Global Research (OGR) U.S.-Japan Cooperative Medical Sciences Program (CMSP), 17th International Conference on Emerging Infectious Diseases (EID)	1	Taipei Survey
Online customer satisfaction survey for collecting feedback on NIH/NIAID grants-related knowledge management needs and resources	1	Online customer satisfaction survey screen shots
The Immunology Database and Analysis Portal (ImmPort) System Customer Satisfaction Surveys	1, 1	Survey Screenshots (Data Users) ,   Survey Screenshots (Data Submitters)
The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	1	Feedback survey
The National Institute of Allergy and Infectious Diseases, Pan-American Health Organization, and World Health Organization, Gaps and Opportunities in Chikungunya Research: Expert Consultation on Chiku	1, 2	Survey Screenshots ,   Survey
User Feedback on NIAID's International Clinical Research Regulatory Matrix (ICRRM)	1	User Feedback on NIAID's (ICRRM)
User Feedback on NIAID's International Clinical Research Regulatory Matrix (ICRRM).	1	User Feedback ICRRM).

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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	28,000	0	0	28,000	0	0
Annual Time Burden (Hours)	48,300	0	0	48,300	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new ICR.

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Annual Cost to Federal Government: $300,000

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: 12/12/2012

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