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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Panelist Interview Guide	Form and Instruction	New	Available
Applicant Interview Guide	Form and Instruction	New	Available
2015 EIS Conference Survey	Form	New	Available
2015 EIS Conference Survey	Form	New	Available
Follow-up survey - screenshots	Form	New	Available
Follow-up survey	Form	New	Available
Initial survey - screenshots	Form	New	Available
Iniital survey	Form	New	Available
60day_2014-09765.pdf	Supplementary Document	Uploaded 2014-10-01	Available
Att C_ Draft GenIC Clearance Submission Template - 4-11.docx	Supplementary Document	Uploaded 2014-10-01	Available
Attachment A_ Applicable Laws or Regulations.docx	Supplementary Document	Uploaded 2014-10-01	Available
SS B_REV_Service Delivery.docx	Supporting Statement B	Uploaded 2014-10-01	Available
SS A_REV2_ Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCBDDD)_OMBcomments.docx	Supporting Statement A	Uploaded 2015-01-07	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
225377	Learn the Signs. Act Early. Customization of Materials Customer Feedback Survey	Other-WORD	New
223249	Learn the Signs. Act Early Bulk Orders	Other-WORD	New
215758	Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD	Form and Instruction	New	Panelist Interview Guide
215758	Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD	Form and Instruction	New	Applicant Interview Guide
215171	Customer Feedback Survey of 2015 EIS Conference	Form	New	2015 EIS Conference Survey
215171	Customer Feedback Survey of 2015 EIS Conference	Form	New	2015 EIS Conference Survey
214699	Learn the Signs. Act Early. Partner Webinars	Form	New	Follow-up survey - screenshots
214699	Learn the Signs. Act Early. Partner Webinars	Form	New	Follow-up survey
214699	Learn the Signs. Act Early. Partner Webinars	Form	New	Initial survey - screenshots
214699	Learn the Signs. Act Early. Partner Webinars	Form	New	Iniital survey

ICR Details

OMB Control No: 0920-0919	ICR Reference No: 201410-0920-001
Status: Historical Active	Previous ICR Reference No: 201112-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/12/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/17/2014
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	01/31/2018	36 Months From Approved	01/31/2015
Responses	12,750	0	28,000
Time Burden (Hours)	10,875	0	18,667
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable National Center on Birth Defects and Developmental Disabilities to garner customer and stakeholder feedback in an efficient and 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): US Code: 42 USC 241 Name of Law: Public Health and Welfare Act
  

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:
	79 FR 24432	04/30/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 60469	10/07/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Assessing Customer Satisfaction with the Extramural Research Program Services Office Serving NCCDPHP and NCBDDD	None, None	Applicant Interview Guide ,   Panelist Interview Guide
Customer Feedback Survey of 2015 EIS Conference	none, none	2015 EIS Conference Survey ,   2015 EIS Conference Survey
Learn the Signs. Act Early Bulk Orders
Learn the Signs. Act Early. Customization of Materials Customer Feedback Survey
Learn the Signs. Act Early. Partner Webinars	none, none, none, none	Iniital survey ,   Initial survey - screenshots ,   Follow-up survey ,   Follow-up survey - screenshots

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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	12,750	28,000	0	-15,250	0	0
Annual Time Burden (Hours)	10,875	18,667	0	-7,792	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Based on the number of burden hours actually used during the initial approval period and the number of respondents involved, a reduction in the number of respondents and burden hours is requested.

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Annual Cost to Federal Government: $365,500

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: 10/17/2014

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