Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 2019 Focus Group Questions	Form and Instruction	New	Repair queued
Form 1 2019 VISTA Focus Group	Form and Instruction	New	Available
Form 1 NCCC Webinar Feedback Survey	Form and Instruction	New	Available
Form 1 Member, Alumni, Grantee/Sponsor Survey	Form and Instruction	New	Available
Form 1 CNCS Nationwide Survey	Form and Instruction	New	Available
Form 1 NCCC Customer Survey	Form and Instruction	New	Available
Form 1 Community Opinion Leaders Discussion Guide	Form and Instruction	New	Available
Form 3 Senior Corps Survey Volunteers	Form and Instruction	New	Available
Form 2 Senior Corps Staff Aurvey	Form and Instruction	New	Available
Form 1 Senior Corps Community Partners Survey	Form and Instruction	New	Available
Form 1 CNCS Organizational Assessment Tool	Form and Instruction	New	Available
Form 2 Senior Corps New Grantee Staff Discussion Guide	Form and Instruction	New	Repair queued
Form 1 Senior Corps New Grantee Volunteer Discussion Guide	Form and Instruction	New	Available
Form 1 VISTA Supervisors Webinar Evaluation	Form	New	Available
Form 1 National Service Hotline Customer Satisfaction Questions	Form	New	Available
Form 1 ASN Symposium Workshop Evaluation	Form	New	Available
Generic Clearance Submission Template.docx	Supplementary Document	Uploaded 2011-04-20	Available
Generic for Feedback Clearance Template Part B 2.10.15.doc	Supporting Statement B	Uploaded 2015-03-09	Available
Generic for Feedback Clearance Template Part A 2.10.15.docx	Supporting Statement A	Uploaded 2015-03-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238957	2019 VISTA Information Collection	Form and Instruction	New	2019 Focus Group Questions
238957	2019 VISTA Information Collection	Form and Instruction	New	2019 VISTA Focus Group
238782	NCCC Webinar Feedback Survey	Form and Instruction	New	NCCC Webinar Feedback Survey
235673	Member, Alumni, Grantee/Sponsor Survey	Form and Instruction	New	Member, Alumni, Grantee/Sponsor Survey
234757	National Survey of General Public	Form and Instruction	New	CNCS Nationwide Survey
234347	NCCC Customer Survey	Form and Instruction	New	NCCC Customer Survey
234046	Community Opinion Leaders Focus Group	Form and Instruction	New	Community Opinion Leaders Discussion Guide
232637	Senior Corps Survey	Form and Instruction	New	Senior Corps Survey Volunteers
232637	Senior Corps Survey	Form and Instruction	New	Senior Corps Staff Aurvey
232637	Senior Corps Survey	Form and Instruction	New	Senior Corps Community Partners Survey
232327	Organizational Assessment Form	Form and Instruction	New	CNCS Organizational Assessment Tool
231378	Senior Corps Feedback Discussion Sessions	Form and Instruction	New	Senior Corps New Grantee Staff Discussion Guide
231378	Senior Corps Feedback Discussion Sessions	Form and Instruction	New	Senior Corps New Grantee Volunteer Discussion Guide
230726	Scaling Questions	Instruction	New
229871	VISTA Supervisor Webinar Evaluation	Form	New	VISTA Supervisors Webinar Evaluation
229870	National Service Hotline Customer Satisfaction Survey	Form	New	National Service Hotline Customer Satisfaction Questions
229867	AmeriCorps Symposium Feedback Form	Form	New	ASN Symposium Workshop Evaluation

ICR Details

OMB Control No: 3045-0137	ICR Reference No: 201709-3045-001
Status: Historical Active	Previous ICR Reference No: 201503-3045-001
Agency/Subagency: CNCS	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/29/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/05/2017
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	05/31/2018
Responses	10,000	0	10,000
Time Burden (Hours)	1,667	0	1,667
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable CNCS to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): US Code: 44 USC 3501 et.seq. Name of Law: Paperwork Reduction Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 31310	07/06/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 41939	09/05/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 13

table that charts list of burden

IC Title	Form No.	Form Name
2019 VISTA Information Collection	1, 2	2019 VISTA Focus Group ,   2019 Focus Group Questions
AmeriCorps Symposium Feedback Form	1	ASN Symposium Workshop Evaluation
Community Opinion Leaders Focus Group	1	Community Opinion Leaders Discussion Guide
Member, Alumni, Grantee/Sponsor Survey	1	Member, Alumni, Grantee/Sponsor Survey
NCCC Customer Survey	1	NCCC Customer Survey
NCCC Webinar Feedback Survey	1	NCCC Webinar Feedback Survey
National Service Hotline Customer Satisfaction Survey	1	National Service Hotline Customer Satisfaction Questions
National Survey of General Public	1	CNCS Nationwide Survey
Organizational Assessment Form	1	CNCS Organizational Assessment Tool
Scaling Questions
Senior Corps Feedback Discussion Sessions	1, 2	Senior Corps New Grantee Volunteer Discussion Guide ,   Senior Corps New Grantee Staff Discussion Guide
Senior Corps Survey	1, 2, 3	Senior Corps Community Partners Survey ,   Senior Corps Staff Aurvey ,   Senior Corps Survey Volunteers
VISTA Supervisor Webinar Evaluation	1	VISTA Supervisors Webinar Evaluation

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	10,000	10,000	0	0	0	0
Annual Time Burden (Hours)	1,667	1,667	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/05/2017

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