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pdfOMB Control No.: 3095-0070
Expiration date: 12-31-2020
Request for Approval under the
“Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”
(OMB Control Number: 3095-0070)
TITLE OF INFORMATION COLLECTION: Security Classification Guide Use Survey
DATE OF REQUEST: 6/18/2020
PURPOSE: To determine if security classification guides are used effectively to facilitate
the proper and uniform derivative classification of information. It aims to draw upon the
experience of the users of the guides with regard to the dissemination of the guides, the
training on their use, the guides’ clarity and ease of use, classification guide content, and
user knowledge.
DESCRIPTION OF RESPONDENTS:
The survey is directed at Executive Branch personnel who derivatively classify and use or
have used security classification guides. It will be deployed in association with a review
of the content of agency security classification guides, which ISOO is currently
conducting throughout the Executive Branch. Agencies that agree to participate will
distribute the survey to its personnel who are likely to meet the above criteria. At some
agencies, all of the personnel will be Federal employees; at others, it will likely include a
combination of Federal employees and contract personnel. We expect to deploy the
survey approximately once every three to four months at individual agencies in this and
the next calendar year, keeping the survey open for one to two weeks each time.
TYPE OF COLLECTION: (Check one)
☐ Customer Comment Card/Complaint Form
☐ Usability Testing (e.g., Website or Software)
☐ Focus Group
☐ Customer Satisfaction Survey
☐ Small Discussion Group
☒ Other: Survey
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: Robert Skwirot
To assist review, please provide answers to the following question:
Page 1 of 3
NA Form 2023 (09-17)
Required by NARA 108
OMB Control No.: 3095-0070
Expiration date: 12-31-2020
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? ☐ Yes ☒ 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
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? ☐ Yes ☒ No
BURDEN HOURS
Category of Respondent
Participation
Time
10 minutes
Burden
Federal Government
No. of
Respondents
750
Private Sector
250
10 minutes
42 hours
Totals
1,000
125 hours
167 hours
FEDERAL COST: The estimated annual cost to the Federal Government is $0.
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 ☒ No
Agencies that agree to participate in the survey will distribute it by email to a subset of
its personnel that it identifies as likely to meet the criteria for participation.
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?
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
☒ Web-based or other forms of Social Media (if applicable, please add url)
☐ Telephone
☐ In-person
☐ Mail
☐ Other, Explain
2. Will interviewers or facilitators be used? ☐ Yes ☒ No
3. Length of Collection: From: Click here to enter a date. To: Click here to enter a date.
Please make sure that all instruments, instructions, and scripts are submitted with the
request.
Page 2 of 3
NA Form 2023 (09-17)
Required by NARA 108
OMB Control No.: 3095-0070
Expiration date: 12-31-2020
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)
DATE OF REQUEST: Enter the date the request is made.
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. Enter the date span “from” and “to” that this survey
will be administered.
Submit all instruments, instructions, and scripts with the request.
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NA Form 2023 (09-17)
Required by NARA 108
File Type | application/pdf |
File Modified | 2020-07-02 |
File Created | 2020-07-02 |