EIA Reporting Preference Survey Generic Clearance Template

Request for Approval under the “Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery” (OMB Control Number: 1905-0210)

EIA Survey Respondent Reporting Preference Survey

PURPOSE: The U.S. Energy Information Administration (EIA) conducts approximately 55 surveys. EIA seeks to assess the reporting capabilities and preferences of respondents to EIA’s surveys in order to standardize the future methods used to collect data from respondents. To collect this information, EIA will utilize an online survey to evaluate the capabilities and preferences of our survey respondents towards a set of defined methods of data collection. This information collection will help EIA identify the current reporting capabilities, future reporting preferences, and help identify issues that may hinder survey respondents from reporting their information to EIA in the future.

DESCRIPTION OF RESPONDENTS: Respondents invited to participate in this research project are survey respondents that report data on one or more of 37 periodic (annual, quarterly, monthly, or weekly) surveys that were selected for this study.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] 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: Joshuah Latimore

Senior Advisor for Data Management

Office of Energy Statistics

U.S. Energy Information Administration

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

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 [ ] No These are statistical records as defined under 5 U.S.C. § 552A(a)(6) maintained for statistical research and not used in whole or in part in making any determination about an identifiable individual. Data will be encrypted when the respondent submits their response to the survey using FIPS 140-2 approved encryption software to protect the PII. The PII will be removed from the survey responses and stored in a separate data user frame file and stored in a restricted access folder.

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Y [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
EIA Survey Respondents	2,460	5 min.	205 hrs.
Totals	2,460	5 min.	205 hrs.

ESTIMATE OF RESPONDENT BURDEN HOURS AND COST

The burden to respondents is 205 hours and the cost to the respondents is estimated to be ($73.66*205) $15,101

FEDERAL COST: There are no additional costs to the federal government anticipated. Expenses (equipment, overhead, printing, and support staff) will be incurred by EIA components as part of their normal operating budgets.

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?

EIA will send invitation notices to active respondents on 37 EIA surveys. EIA will place a priority on inviting multi-survey respondents, i.e., respondents who report on multiple EIA surveys, to participate in this research project. In addition to all of the multi-survey respondents, EIA will also solicit the participation of respondents that only report on one EIA survey for those surveys where the number of multi-survey respondents is less than 100. Respondents who only report on one EIA survey will be invited to participate, and where applicable sampled, until the combined number of responses is equal to 100 for that survey.

There are several surveys where the survey frame has less than 100 respondents. If the combined number of respondents in the survey frame (Single and Multi) is less than 100 then, all of the multi-survey respondents and single survey respondents will invited to participate.

See table below for the list of 37 surveys that EIA will solicit participants

Surveys
EIA-111	EIA-815
EIA-22M	EIA-816
EIA-23L	EIA-817
EIA-3	EIA-819
EIA-411	EIA-820
EIA-63B	EIA-821
EIA-63C	EIA-851A
EIA-64A	EIA-851Q
EIA-7A	EIA-858
EIA-800	EIA-860
EIA-802	EIA-860M
EIA-803	EIA-861
EIA-804	EIA-861S
EIA-805	EIA-886
EIA-809	EIA-8A
EIA-810	EIA-914
EIA-812	EIA-923A
EIA-813	EIA-923M
EIA-814

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

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

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Submit all instruments, instructions, and scripts are submitted with the request.

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