Justification template

DOCUMENTATION FOR THE GENERIC CLEARANCE

OF CUSTOMER SERVICE SATISFACTION COLLECTIONS

TITLE OF INFORMATION COLLECTION: Repayment Direct Customer Survey

(the collection that is the subject of the 10-day review request)

[ X] SURVEY [ ] FOCUS GROUP [ ] SOFTWARE USABILITY TESTING

DESCRIPTION OF THIS SPECIFIC COLLECTION

Specify all relevant information, including

1. intended purpose, The purpose of this survey is to determine the impact of our outreach presentations, allow customers a chance to provide feedback, and evaluate the ways we can continue to serve our constituents.

2. need for the collection, This information is needed to evaluate our the effectiveness of our presentations.

3. planned use of the data, We plan to use the data internally to review customers feedback that will allow us to improve our practices accordingly.

4. date(s) and location(s), The survey will be sent electronically after every outreach presentation to our direct customers.

5. collection procedures, We will distribute the surveys and collect the responses electronically through Survey Monkey.

6. number of focus groups, surveys, usability testing sessions, There will only be one survey sent per attendant per presentation.

7. description of respondents/participants. The respondents are students and families who attended an outreach presentation.

(State whether the data collection will be completed one time, will be collected on an annual basis, or other.)

This survey will be sent to out to participants in our outreach presentations. The survey is designed to allow customers to not only evaluate the presentation but also provide any additional feedback about FSA support and services.

Attach a copy of the proposed collection instrument, e.g., survey questions, focus group script, usability testing plan. If a focus group also includes a survey, include both.

AMOUNT OF ANY PROPOSED STIPEND OR INCENTIVE

No payments, stipends or incentives are planned.

BURDEN HOUR COMPUTATION (Number of responses (X) estimated response or participation time in minutes (/60) = annual burden hours):

Category of Respondent	No. of Respondents	Participation Time	Burden
	1250	5 minutes	104
Totals	1250	5 minutes	104

Because this survey will be sent out to participants at all our out outreach events, the audience sizes will vary greatly. We cannot predict the number of respondents for each of the events that may occur. However, the survey only has 9 questions and should take about 5 minutes to complete.

STATISTICAL INFORMATION

If statistical methods are to be used, fully describe the methodology, sample selection, expected response rates, and any other concepts needed to provide a full understanding of those methods.

This survey does not employ statistical methods.

REQUESTED APPROVAL DATE: 11/10/15

NAME OF CONTACT PERSON: Claire Fluker

TELEPHONE NUMBER: 202-377-4580

MAILING LOCATION: 830 First Street NE 32C2 Washington DC, 20202

ED DEPARTMENT, OFFICE: FSA

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