CBP Applicant Exam No-Show Survey_Submission Form

CBP Applicant Exam No Show Survey_Submission Form.doc

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

CBP Applicant Exam No-Show Survey_Submission Form

OMB: 1651-0136

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1651-0136)

T ITLE OF INFORMATION COLLECTION: CBP Applicant Exam No-Show Survey


PURPOSE: The purpose of this information collection is to understand from applicants who apply to CBP Officer and Border Patrol Agent positions, but do not show for their scheduled entrance examination, if there are any aspects of the communications or design of the entrance examination process that created unintended obstacles for this stakeholder group.


DESCRIPTION OF RESPONDENTS: An email invitation to complete the survey will be sent to applicants who applied to the CBP Officer or Border Patrol Agent position, scheduled an appointment to complete the entrance examination, but failed to show for their scheduled examination time. This survey is to ask respondents why they did not show for their scheduled entrance examination.


TYPE OF COLLECTION: (Check one)


[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ X] Other: _Online survey


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:_Kathlea Vaughn_____________________


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 [ ] 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

1000

3 minutes

50





Totals

1000

3

50


FEDERAL COST: The estimated annual cost to the Federal government is $0__


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?


CBP will receive from OPM a list of all applicants who did not show for their scheduled entrance examination appointment. All of these individuals will receive an email requesting their feedback via this 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

[ ] Other, Explain

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

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

The following materials are submitted with this form: both versions of the survey in MS Word, the surveys as they will be presented online (HTML archive file), and emails to be sent to the respondents (invitation, reminder, and thanks/confirmation of receipt).


Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”


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 (in minutes) 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 Respondents and the Participation Time then 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.

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File Typeapplication/msword
File TitleFast Track PRA Submission Short Form
AuthorOMB
Last Modified ByMEGAN, FREDERICK
File Modified2015-12-23
File Created2015-11-04

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