Gen IC Application

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1652-0058)

TITLE OF INFORMATION COLLECTION: TSA Product Feedback Survey

PURPOSE: To gather information on the value of TSA products to the respondents

DESCRIPTION OF RESPONDENTS: Transportation Security Stakeholders

TYPE OF COLLECTION: (Check one)

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

[ ] Usability Testing (such as 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:_Michael Colman___________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ X ] Yes [ ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [X ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [X ] Yes [ ] No

Gifts or Payments:

Is an incentive (such as 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
State, Local, or tribal governments	333	0.083	28
Totals

FEDERAL COST: The estimated annual cost to the Federal government is: $4,403.4¹

TSA Position and Grade	Average Hourly Loaded Rate of Pay	Estimated Number of Hours	Estimated Number of Annual Reviews	Estimated Annual Cost to the Federal Government
Program Manager/ K-Band	$92.90	0.083	222	$1,713.5
Contractor/ Project Manager	$92.90	0.083	222	$1,713.5
Contractor/ Analyst	$52.94	0.083	222	$976.4
	Total Estimated Annual Cost to the Federal Government			$4,403.4

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?

For purposes of this collection, the potential group of respondents consists of all Transportation Security Stakeholders that read a TSA Transportation Security Information product. Completing and submitting the survey is voluntary. There is no sampling plan intended; all valid responses will be used.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X ] Web-based or other forms of Social Media

[ X ] Telephone

[ X ] In-person

[ X ] Mail

[ ] Other, Explain

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

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

1 TSA assumes an average time to complete the survey of 5 minutes per respondent. TSA also assumes 1,000 government respondents, one-third of which are assumed to be in the state, local, or tribal governments, with the other two thirds distributed equally across the other government employee types. The loaded hourly wage for a K-Band is $92.90, which was extracted from the FY 2016 Modular Costs Standards Workbook for TSA. The same wage was applied to Contractor/Project Manager, while the loaded hourly wage for a mid-level government employee (GS 9-12) of $52.94 was used for the Contractor/Analyst.

4