Short Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1545-2208)

T ITLE OF INFORMATION COLLECTION:

Appeals ATCL Conferencing Initiative Survey

PURPOSE:

This survey will gather feedback from IRS personnel, and taxpayers that participated in the Appeals Team Case Lead Conferencing Initiative. The ATCL Conferencing Initiative supports our mission is to resolve tax matters, without litigation, on a basis which is fair and impartial to both the government and the taxpayer. The survey is broken up into three parts, 1.) For all ATCL volunteers 2.) For taxpayers that participated in a case and 3.) For Exam teams (IRS employees) that participated in a case. The analysis of the survey responses will provide Appeals with feedback about the initiative.

DESCRIPTION OF RESPONDENTS:

The respondents will be those who volunteered to participate in the conferencing initiative if they choose to volunteer to complete the survey via survey manager. The potential survey respondents would be Appeals employees (ATCL-Appeals Team Case Leads), SBSE Exam Team Manager employees, taxpayers or their representatives.

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: ____________Jodi Tyskiewicz__________________

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

Personally Identifiable Information:

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

Email addresses & Survey volunteer’s name.

Personally Identifiable Information (PII) is collected only to the extent necessary and is not retained.

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

3. If “Yes”, has an up-to-date System of Records Notice (SORN) been published? [ x ] Yes [ ] 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 (minutes)	Burden
IRS employees	313	15	78.25
Taxpayers/Representatives	300	15	75.00
Totals	613	30	153.25

FEDERAL COST: The estimated annual cost to the Federal government is $_____0.00__.

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?

The potential respondents are those who volunteered to participate in the Appeals Team Case Lead Conferencing initiative. There is no sampling plan. Each person who participated in the initiative will be email a survey via survey manager. It is entirely voluntary to participate in the survey.

Administration of the Instrument

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

[ x ] Web-based or other forms of Social Media Survey Manager

[ ] 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.

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