Template Justification

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1880-0542)

TITLE OF INFORMATION COLLECTION:

Privacy Technical Assistance Center (PTAC) and Family Policy Compliance Office (FPCO) Customer Satisfaction Survey

PURPOSE: To assess the quality and relevance of PTAC’s and FPCO’s technical assistance activities and resources.

DESCRIPTION OF RESPONDENTS: Officials from state and local educational agencies.

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:____Michael Hawes __________________

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, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice 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 and local educational agency officials	1000 (estimate)	2 minutes	33 hours
Totals	1000 (estimate)	2 minutes	33 hours

FEDERAL COST: The estimated annual cost to the Federal government is $__25___

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?

[ ] Yes [X] 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 intend to administer the Customer Satisfaction Survey in two different ways. A link to an electronic version will be included in the footer of each PTAC and FPCO email message to our external stakeholders. We will also administer a paper version to those individuals attending PTAC/FPCO trainings, conference presentations, site visits, regional meetings, etc.

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

[X] 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.

See Attached.

NOTE: The Privacy Technical Assistance Center and the Family Policy Compliance Office each offer technical assistance to the same audience (state and local education officials). While FPCO’s assistance focuses on compliance issues relating to requirements of federal law, PTAC offers broader best practice recommendations that go beyond minimum compliance. As such, these two operations are closely related, and provide similar services. Consequently, we are seeking to use the same customer survey questions to evaluate the service offerings of both operations. In the attached questions, the designation “(PTAC/FPCO)” indicates those places where either “PTAC” or “FPCO” will be inserted, as appropriate, for their respective surveys. Similarly, since both PTAC and FPCO provide their technical assistance services through a number of media (in person, through guidance documents, via webinar, through email help-desks, etc.) we are looking to tailor the survey questions to the media in which the service was offered. Consequently, we have included three sets of questions: one set to evaluate webinars and presentations, one for customer feedback on help-desk assistance, and a general one for members of the PTAC and FPCO listservs. At any given time, only the relevant questions will be asked (i.e., attendees of a presentation will not be asked the questions related to the listserv, and vice-versa.).

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