TITLE OF INFORMATION COLLECTION:
User Satisfaction and Analytics
PURPOSE:
This information collection will be used to gather satisfaction data, with the purpose of not only supplying customer agencies with the various pieces of feedback they desire, but also compiling comprehensive analytics based on overarching survey outcomes.
DESCRIPTION OF RESPONDENTS:
The desired respondents are users and patrons of Federal agency websites.
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:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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: ____Christian Simpson____________________________________________
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [X] No
If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
If Yes, has an up-to-date System of Records Notice (SORN) 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 |
Federal Government (employees and non-employees) |
1000 |
5/60 |
83 |
Totals |
|
|
|
FEDERAL COST: The estimated annual cost to the Federal government is ____$0.00__________
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
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
Federal Occupational Health (FOH) is an unappropriated shared services agency within the Program Support Center. FOH is dependent upon revenue from its Federal agency customers to maintain and meet its budget and staffing needs. The customer service survey clearance will allow FOH to identify agencies that seek data relating to customer satisfaction, and allow said agencies to enter into interagency agreements with FOH to utilize paid survey services. As a result, identifying the number of Federal Government respondents is guesswork at best. However, after contracting with agencies to provide customer satisfaction surveys, we do know that the respondents will self-select. They will choose whether to rate their customer service experience, or decline the opportunity. Therefore the universe of respondents will be those who have utilized the agency’s web-based services, and decided that they would like to rate their experience concerning the website specifically, or the agency services generally.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Other, Explain
Will interviewers or facilitators be used?
[ ] Yes [X] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
**2 Sample survey instruments attached
TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g., Comment card for soliciting feedback on xxxx)
PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.
DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.
TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.
CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.
Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.
Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.
BURDEN HOURS:
Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.
No. of Respondents: Provide an estimate of the Number of respondents.
Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)
Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.
FEDERAL COST: Provide an estimate of the annual cost to the Federal government.
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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.
Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.
Submit all instruments, instructions, and scripts are submitted with the request.
File Type | application/msword |
File Title | DOCUMENTATION FOR THE GENERIC CLEARANCE |
Author | 558022 |
Last Modified By | Funn, Sherrette (OS/ASA/OCIO/OEA) |
File Modified | 2014-12-12 |
File Created | 2014-12-12 |