na-2023_ACRS_S_Fawcett

OMB 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: Machine Readable Data Feedback Survey

DATE OF REQUEST: 12/12/2019

PURPOSE: Federal agencies and public interest groups have long expressed interest in having the records control schedules in machine-readable form. In response to this interest, AC/ACRS will post machine-readable schedule data (in .cvs format) on data.gov in January 2020. The purpose of this survey is to collect feedback from users who download the data to determine if the data/format/data elements meets their needs. In addition, we are interested in users suggestions/recommendations regarding how to make the data more useful and accessible 

DESCRIPTION OF RESPONDENTS: Primarily Federal Agencies, Public Interest Groups, Researchers

TYPE OF COLLECTION: (Check one)

Customer comment card/Complaint form 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: Stephanie Fawcett

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

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 respondents	No. of respondents	Participation time	Burden
	200	7	23
	     	     	     
Totals	200	7	23

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

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: 1/15/2020 To: 3/31/2020

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 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 respondents 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.

Page 5 of 5

NA Form 2023 (09-17)

Required by NARA 108