Formative Studies on NIOSH Communications and Publications: NIOSH Customer Satisfaction Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form No number NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents	Form	Removed	Available
Form 0920-0544 NIOSH Customer Satisfaction Survey - Short/Employer	Form and Instruction	New	Available
Form 0920-0544 NIOSH Customer Satisfaction Survey - Short/Intermediary	Form and Instruction	New	Available
Form 0920-0544 NIOSH Customer Satisfaction Survey - Full/Employer	Form and Instruction	New	Available
Form 0920-0544 NIOSH Customer Satisfaction Survey - Full/Intermediary	Form and Instruction	New	Available
Form No number NIOSH Customer Satisfaction Survey - Unfamiliar with NIOSH respondents	Form	Removed	Available
Attachment 8.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att. 7a CS Report 2009 Battelle.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att.7b CS 2003 Report (NCS) Cover.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att 6. 16-IRB.pdf	Supplementary Document	Uploaded 2017-11-28	Available
Att 5c.Invitation after first refusal.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att 5b.FAQs.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att. 5a.RespondentInstructions.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att 4c.2nd&FinalFollowUpEmail.docx	Supplementary Document	Uploaded 2017-11-28	Available
Attachment 4b.1stFollowUpEmail.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att 4a.RecruitingEmail.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att. 1 Authorizing Legislation.docx	Supplementary Document	Uploaded 2017-11-28	Available
Att B 60-Day NIOSH Customer Satisfication.pdf	Supplementary Document	Uploaded 2017-11-28	Available
SSB 21FEB2018.docx	Supporting Statement B	Uploaded 2018-02-26	Available
SSA 21FEB2018.doc	Supporting Statement A	Uploaded 2018-02-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6995	NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents	Form	Removed
229157	NIOSH Customer Satisfaction Survey - Short/Employer	Form and Instruction	New
229156	NIOSH Customer Satisfaction Survey - Short/Intermediary	Form and Instruction	New
229155	NIOSH Customer Satisfaction Survey - Full/Employer	Form and Instruction	New
229154	NIOSH Customer Satisfaction Survey - Full/Intermediary	Form and Instruction	New
188230	NIOSH Customer Satisfaction Survey - Unfamiliar with NIOSH respondents	Form	Removed

ICR Details

OMB Control No: 0920-0544	ICR Reference No: 201711-0920-003
Status: Historical Active	Previous ICR Reference No: 200903-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0544
Title: Formative Studies on NIOSH Communications and Publications: NIOSH Customer Satisfaction Survey
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/27/2018
	Date Received in OIRA: 11/29/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2020	24 Months From Approved	04/30/2010
Responses	1,500	0	720
Time Burden (Hours)	312	0	205
Cost Burden (Dollars)	0	0	0

---

Abstract: NIOSH seeks OMB approval of a Customer Satisfaction Survey of occupational safety and health professionals. This is a Reinstatement with Change (0920-0544, Expiration Date, 4/30/2010) and NIOSH is requesting a 2-year approval period. The survey is directed at four associations, as well as additional partnering organizations to enable NIOSH to determine the level of customer satisfaction and provide recommendations for improving development and dissemination of NIOSH publications and products.

---

Authorizing Statute(s): PL: Pub.L. 91 - 596 20[a][1] Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 64157	09/19/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 56025	11/27/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
NIOSH Customer Satisfaction Survey - Full/Intermediary	0920-0544	CSI Survey Full Intermediary Version
NIOSH Customer Satisfaction Survey - Short/Employer	0920-0544	CSI Survey Short Employer Version
NIOSH Customer Satisfaction Survey - Full/Employer	0920-0544	CSI Survey Full Employer Version
NIOSH Customer Satisfaction Survey - Short/Intermediary	0920-0544	CSI Survey Shortl Intermediary Version
NIOSH Customer Satisfaction Survey- Familiar with NIOSH respondents	No number	NIOSH Customer Satisfaction Survey
NIOSH Customer Satisfaction Survey - Unfamiliar with NIOSH respondents	No number	NIOSH Customer Satisfaction Survey

---

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	1,500	720	0	780	0	0
Annual Time Burden (Hours)	312	205	0	107	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: Submission of 0920-0544 is a Reinstatement with Change that includes sampling from additional partnering organizations.

---

Annual Cost to Federal Government: $70,350

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     Yes

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

---

Common Form ICR:  No

---

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: 11/29/2017

---