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

Forms and Documents

Document Name	Status
Form FEMA Form 519-0-42 Customer Satisfaction Survey for the Sheltering and Temporary Essential Power Program Form	New
Form FEMA Form 519-0-17 DisasterAssistance.gov Customer Satisfaction Survey Form	New
Form FEMA Form 519-0-24 NFIP Customer Experience Form and Instruction	New
Form FEMA Form 519-0-13 Online Survey Assessing Representatives of Organizations Serving Individuals with Limited English Proficiency Emergency Management Needs and Preferences Form	New
Form FEMA Form 519-0-11 America's PrepareAthon Customer Satisfaction Survey Form	New
Form FEMA Form 092-0-3 Emergency Management Institute Course Evaluation Form Form	New
Form FEMA Form 519-0-1 Emergency Management Institute Follow-up Evaluation Survey Form	New
Form FEMA Form 519-0-2 Qualitative Feedback on U.S. Fire Administration's Analytical Reports Form	New
Form FEMA Form 519-0-15 Fire is Everyone's Fight Initiative Form	New
Supporting Statement 1660-0130_Part A_041315.docx Supporting Statement A	2015-04-13
Part_B_Supporting_Statement_1660-0130__FEMA_Generic_Clearance_for_the_Collection_of_Qualitative_Feedback_on_Agency_Service_Delivery[1].docx Supporting Statement B	2015-04-08
Pub 30 day FRN_1660-0130.pdf Supplementary Document	2014-10-16
Generic Clearance Application.pdf Supplementary Document	2015-04-08
Pub 60 day FRN 08042014.pdf Supplementary Document	2014-09-23
Executive Order 12862.docx Supplementary Document	2011-06-21

IC Document Collections

IC ID	Document Title	Status
224302	Customer Satisfaction Survey for the Sheltering and Temporary Essential Power Program Form	New
220467	DisasterAssistance.gov Customer Satisfaction Survey Form	New
218742	NFIP Customer Experience Form and Instruction	New
218498	Online Survey Assessing Representatives of Organizations Serving Individuals with Limited English Proficiency Emergency Management Needs and Preferences Form	New
216550	America's PrepareAthon Customer Satisfaction Survey Form	New
216549	Emergency Management Institute Course Evaluation Form Form	New
216548	Emergency Management Institute Follow-up Evaluation Survey Form	New
216547	Qualitative Feedback on U.S. Fire Administration's Analytical Reports Form	New
216543	Fire is Everyone's Fight Initiative Form	New

ICR Details

OMB Control No: 1660-0130	ICR Reference No: 201504-1660-001
Status: Historical Active	Previous ICR Reference No: 201409-1660-005
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/01/2015
	Date Received in OIRA: 04/13/2015
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.¿

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	36 Months From Approved	05/31/2015
Responses	1,075,000	0	173,800
Time Burden (Hours)	181,995	0	20,142
Cost Burden (Dollars)	0	0	0

---

Abstract: This collection of information is necessary to enable the Agency 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. This feedback will provide insights into customer or stakeholder perceptions, experiences and expectations, provide an early warning of issues with service, or focus attention on areas where communication, training or changes in operations might improve delivery of products or services. These collections will allow for ongoing, collaborative and actionable communications between the Agency and its customers and stakeholders. It will also allow feedback to contribute directly to the improvement of program management.

---

Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 45209	08/04/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 61887	10/15/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
Online Survey Assessing Representatives of Organizations Serving Individuals with Limited English Proficiency Emergency Management Needs and Preferences	FEMA Form 519-0-13	Survey Questions for Organizations Serving Individuals with Limited English Proficiency (LEP)
Fire is Everyone's Fight Initiative	FEMA Form 519-0-15	Fire is Everyone's Fight Initiative
Emergency Management Institute Course Evaluation Form	FEMA Form 092-0-3	Emergency Management Institute Course Evaluation Form
America's PrepareAthon Customer Satisfaction Survey	FEMA Form 519-0-11	America's PrepareAthon Customer Satisfaction Survey
DisasterAssistance.gov Customer Satisfaction Survey	FEMA Form 519-0-17, FEMA Form 519-0-17, FEMA Form 519-0-17	Registration Intake (RI) DisasterAssistance.gov Customer Satisfaction Survey ,   General DisasterAssistance.gov Customer Satisfaction Survey ,   Applicant Inquiry (AI) DisasterAssistance.gov Customer Satisfaction Survey
Emergency Management Institute Follow-up Evaluation Survey	FEMA Form 519-0-1	Emergency Management Institute Follow-up Evaluation Survey
NFIP Customer Experience	FEMA Form 519-0-24	NFIP Customer Experience Survey
Qualitative Feedback on U.S. Fire Administration's Analytical Reports	FEMA Form 519-0-2	Qualitative Feedback on U.S. Fire Administration's Analytical Reports
Customer Satisfaction Survey for the Sheltering and Temporary Essential Power Program	FEMA Form 519-0-42	Sheltering Temporary Essential Power (STEP) Survey (Script)

---

ICR Summary 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	1,075,000	173,800	0	0	901,200	0
Annual Time Burden (Hours)	181,995	20,142	0	0	161,853	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: No

Burden Reduction Due to:

Short Statement: There has been a program adjustment increase from 20,142 to 181,995 annual burden hours. The adjustment is due to an increase in the number of evaluation and surveys received and future submissions that may be subject to the fast-track generic clearance process. Therefore, +148,643 hours were added to the original 18,777 hours requested for evaluations and surveys, while +11,550 hours for focus groups and +1,660 hours for customer comment cards.

---

Annual Cost to Federal Government: $1,997,899

Does this IC contain surveys, censuses, or employ statistical methods? No

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

---

Common Form ICR:  No

---

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: 04/13/2015

---