C&P Fast Track Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2125-0628)

TITLE OF INFORMATION COLLECTION: Comment on Conditions and Performance (C&P) Report

PURPOSE: To collect feedback from online readers of the C&P report including:

• Group affiliation

• Primary interests in C&P Report

• Primary job title or responsibility

• Current way they hear about the report

• Preferences for future reports (i.e., print vs. electronic)

DESCRIPTION OF RESPONDENTS:

• Media (News and Print)

• Research Agencies/Universities

• Transportation Groups/Associations

• Public Policy Groups/Associations

• Special Interest Groups

TYPE OF COLLECTION: (Check one)

[X] Customer Comment Card/Complaint Form [ ] 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:_J. Woody Stanley, Office Director (Acting), Transportation Policy Studies

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 [X ] 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 (Hours)
Media (News and Print)	60	15 min.	15
Research Agencies/Universities	60	15 min.	15
Transportation Groups/Associations	48	15 min.	12
Public Policy Groups/Associations	48	15 min.	12
Special Interest Groups	60	15 min.	15
Totals	276	15 min. avg.	69

FEDERAL COST: The estimated annual cost to the Federal government is $48,000 to compile and analyze feedback (under contract).

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?

Any reader who accesses the C&P report at the FHWA public web site will be given the opportunity to reply and submit feedback.

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

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

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