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pdfRequest for Approval under the “Generic Clearance for the Collection of Routine
Customer Feedback” (OMB Control Number 1513–0132)
TITLE OF INFORMATION COLLECTION:
TTB Outreach Event Satisfaction Survey (2019).
PURPOSE:
Alcohol and Tobacco Tax and Trade Bureau (TTB) holds various in-person and webbased outreach events (seminars, presentations, webinars) for alcohol and tobacco
industry members to explain TTB regulations, policies, and other matters, such as its
submission requirements for alcohol formula approval requests. The results of this
customer satisfaction survey will provide (TTB) with high-level feedback on how well the
Bureau is meeting its customer service goals of providing effective outreach that
facilitates voluntary compliance.
DESCRIPTION OF RESPONDENTS:
Respondents to this survey are current alcohol or tobacco permit or brewer’s notice
holders who have attended a TTB outreach event. All respondents are either in or
associated with the industries regulated by TTB.
TYPE OF COLLECTION: (Check one) Place “X” in appropriate box.
[ ] 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.
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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:
Digitally signed by Janelle
Christian
Date: 2019.07.18 07:45:24 -07'00'
__________________________________________
Janelle Christian
Janelle Christian
To assist review, please provide answers to the following question:
Personally Identifiable Information: Check appropriate boxes.
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 [X] N/A
3. If Yes, has an up-to-date System of Records Notice (SORN) been published?
[ ] Yes [ ] No [X] N/A
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation)
provided to participants? [ ] Yes [X] No
BURDEN HOURS Enter appropriate number of respondents, time, and burden, which
is calculated as “No. of respondents x Time per response = Burden”.
Category of
Respondent
No. of
Respondents
Participation Time
Burden
Private Sector
100
9 minutes
15 hours
Totals
100
9 minutes
15 hours
FEDERAL COST: The estimated annual cost to the Federal government is $300.
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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.)
Response: For each TTB outreach activity (e.g., seminar or presentation) we will create
a unique QR Code and a short URL, which we will insert into the outreach activity’s
PowerPoint presentation. The QR Code and URL will be visible to the audience at the
beginning and end of the presentation, at which time attendees can scan or type it into
their Web browser in order to access the survey. The link will take attendees to a
survey on a TTB webpage that will be hosted by SurveyMonkey, an external website.
We will keep the URL active for two weeks, at which time we will redirect the link to the
PowerPoint presentation and compile the survey results. We do not collect the email
address or require a registration for most TTB outreach activities, so sending an email
or other invitation to participate is not a viable option.
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.
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Instructions for completing Request for Approval under the “Generic Clearance for
the Collection of Routine Customer Feedback”
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
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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 with the request.
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File Type | application/pdf |
File Title | Microsoft Word - Justification Statement - TTB Outreach Event Satisfaction Survey (Final) |
Author | Jchristia |
File Modified | 2019-07-18 |
File Created | 2019-07-18 |