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 FF-1040FY-21-107 Long Term Recovery Study - Reconstruction II: 24 Months - Electronic Questionnaire Four	Form and Instruction	New	Repair queued
Form FF-104-FY-21-106 Long Term Recovery Study - Reconstruction II: 24 Months - Phone Questionnaire Four	Form and Instruction	New	Repair queued
Form FF-104-FY-21-105 Long Term Recovery Study - Reconstruction I: 18 Months - Electronic Questionnaire Three	Form and Instruction	New	Repair queued
Form FF-104-FY-21-104 Long Term Recovery Study - Reconstruction I: 18 Months - Phone Questionnaire Three	Form and Instruction	New	Repair queued
Form FF-104-FY-21-103 Long Term Recovery Study - Reconstruction I: 12 Months - Electronic Questionnaire Two	Form and Instruction	New	Repair queued
Form FF-104-FY-21-102 Long Term Recovery Study - Reconstruction I: 12 Months - Phone Questionnaire Two	Form and Instruction	New	Repair queued
Form FF-104-FY-21-101 Long Term Recovery Survey - Restoration: 6 Months - Electronic Questionnaire One	Form and Instruction	New	Repair queued
Form FF-104-FY-21-100 Long Term Recovery Survey - Restoration: 6 Months - Phone Questionnaire One	Form and Instruction	New	Repair queued
Form FEMA GO System Sur FEMA GO Survey	Form and Instruction	New	Repair queued
Form 519-0-61 FEMA NCP Questionnaire	Form and Instruction	New	Available
Form 092-0-1 CAMPUS SUPPORT AND FACILITIES	Form and Instruction	New	Repair queued
Form 092-0-3 COURSE EVALUATION FORM	Form and Instruction	New	Repair queued
Form 092-0-2 FIELD FORCE OPERATIONS (FFO)	Form and Instruction	New	Repair queued
Form FEMA Form 519-0-57 Interactive Voice Response Post Call Survey Spanish Verion	Form and Instruction	New	Available
Form FEMA Form 519-0-57 Interactive Voice Response Post Call Survey	Form and Instruction	New	Available
Form FEMA Form 519-0-57 Interactive Voice Response Post Call Survey Spanish Version	Form and Instruction	New	Available
Form FEMA Form 519-0-57 Interactive Voice Response Post Call Survey	Form and Instruction	New	Available
Form FEMA Form 519-0-42 Sheltering Temporary Essential Power (STEP) Survey (Script)	Form	Removed	Available
Form FEMA Form 519-0-17 Applicant Inquiry (AI) DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	Available
Form FEMA Form 519-0-17 General DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	Available
Form FEMA Form 519-0-17 Registration Intake (RI) DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	Available
Form FEMA Form 519-0-24 NFIP Customer Experience Survey	Form and Instruction	Removed	Available
Form FEMA Form 519-0-13 Survey Questions for Organizations Serving Individuals with Limited English Proficiency (LEP)	Form	Removed	Repair queued
Form FEMA Form 519-0-11 America's PrepareAthon Customer Satisfaction Survey	Form	Removed	Available
Form FEMA Form 092-0-3 Emergency Management Institute Course Evaluation Form	Form	Removed	Available
Form FEMA Form 519-0-1 Emergency Management Institute Follow-up Evaluation Survey	Form	Removed	Available
Form FEMA Form 519-0-2 Qualitative Feedback on U.S. Fire Administration's Analytical Reports	Form	Removed	Available
Form FEMA Form 519-0-15 Fire is Everyone's Fight Initiative	Form	Removed	Available
Part B, Supporting Statement for OMB Collection 1660-0130 (Generic Clearance).docx	Supporting Statement B	Uploaded 2018-02-26	Available
Supporting Statement for OMB Collection 1660-0130 (Generic Clearance), Part A (Updated).docx	Supporting Statement A	Uploaded 2018-03-14	Available
Published 30 Day FRN for OMB Collection 1660-0130, 2-7-2018.pdf	Supplementary Document	Uploaded 2018-02-26	Available
Generic Clearance Application.pdf	Supplementary Document	Uploaded 2015-04-08	Available
Published 60 Day FRN for OMB Collection 1660-0130, 9-13-2017.pdf	Supplementary Document	Uploaded 2018-02-26	Available
Executive Order 12862.docx	Supplementary Document	Uploaded 2011-06-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction II: 24 Months - Electronic Questionnaire Four
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction II: 24 Months - Phone Questionnaire Four
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction I: 18 Months - Electronic Questionnaire Three
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction I: 18 Months - Phone Questionnaire Three
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction I: 12 Months - Electronic Questionnaire Two
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Study - Reconstruction I: 12 Months - Phone Questionnaire Two
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Survey - Restoration: 6 Months - Electronic Questionnaire One
248005	Long Term Recovery (LTR) Survey Study	Form and Instruction	New	Long Term Recovery Survey - Restoration: 6 Months - Phone Questionnaire One
245492	FEMA GO Usability Survey	Form and Instruction	New	FEMA GO Survey
243817	Customer Satisfaction Survey for FEMA Go	Other-Mock Up	New
240060	FEMA National Continuity Stakeholder Survey	Form and Instruction	New	FEMA NCP Questionnaire
239918	FEMA National Training and Education Division (NTED) Training Evaluation Level 1 Student "Reaction" Surveys for the Center for Domestic Preparedness (CDP) and Emergency Management Institute (EMI)	Form and Instruction	New	CAMPUS SUPPORT AND FACILITIES
239918	FEMA National Training and Education Division (NTED) Training Evaluation Level 1 Student "Reaction" Surveys for the Center for Domestic Preparedness (CDP) and Emergency Management Institute (EMI)	Form and Instruction	New	COURSE EVALUATION FORM
239918	FEMA National Training and Education Division (NTED) Training Evaluation Level 1 Student "Reaction" Surveys for the Center for Domestic Preparedness (CDP) and Emergency Management Institute (EMI)	Form and Instruction	New	FIELD FORCE OPERATIONS (FFO)
234512	Interactive Voice Response (IVR) Post-Call Satisfaction Survey	Form and Instruction	New	Interactive Voice Response Post Call Survey Spanish Verion
234512	Interactive Voice Response (IVR) Post-Call Satisfaction Survey	Form and Instruction	New	Interactive Voice Response Post Call Survey
234512	Interactive Voice Response (IVR) Post-Call Satisfaction Survey	Form and Instruction	New	Interactive Voice Response Post Call Survey Spanish Version
234512	Interactive Voice Response (IVR) Post-Call Satisfaction Survey	Form and Instruction	New	Interactive Voice Response Post Call Survey
224302	Customer Satisfaction Survey for the Sheltering and Temporary Essential Power Program	Form	Removed	Sheltering Temporary Essential Power (STEP) Survey (Script)
220467	DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	Applicant Inquiry (AI) DisasterAssistance.gov Customer Satisfaction Survey
220467	DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	General DisasterAssistance.gov Customer Satisfaction Survey
220467	DisasterAssistance.gov Customer Satisfaction Survey	Form	Removed	Registration Intake (RI) DisasterAssistance.gov Customer Satisfaction Survey
218742	NFIP Customer Experience	Form and Instruction	Removed	NFIP Customer Experience Survey
218498	Online Survey Assessing Representatives of Organizations Serving Individuals with Limited English Proficiency Emergency Management Needs and Preferences	Form	Removed	Survey Questions for Organizations Serving Individuals with Limited English Proficiency (LEP)
216550	America's PrepareAthon Customer Satisfaction Survey	Form	Removed	America's PrepareAthon Customer Satisfaction Survey
216549	Emergency Management Institute Course Evaluation Form	Form	Removed	Emergency Management Institute Course Evaluation Form
216548	Emergency Management Institute Follow-up Evaluation Survey	Form	Removed	Emergency Management Institute Follow-up Evaluation Survey
216547	Qualitative Feedback on U.S. Fire Administration's Analytical Reports	Form	Removed	Qualitative Feedback on U.S. Fire Administration's Analytical Reports
216543	Fire is Everyone's Fight Initiative	Form	Removed	Fire is Everyone's Fight Initiative

ICR Details

OMB Control No: 1660-0130	ICR Reference No: 201802-1660-005
Status: Historical Active	Previous ICR Reference No: 201504-1660-001
Agency/Subagency: DHS/FEMA	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: 10/16/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/01/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2021	36 Months From Approved	10/31/2018
Responses	1,075,000	0	1,075,000
Time Burden (Hours)	269,495	0	181,995
Cost Burden (Dollars)	0	0	0

---

Abstract: This collection of information is necessary to enable the Agency 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. This feedback will provide insights into customer or stakeholder perceptions, experiences and expectations, provide an early warning of issues with service, or focus attention on areas where communication, training or changes in operations might improve delivery of products or services. These collections will allow for ongoing, collaborative and actionable communications between the Agency and its customers and stakeholders. It will also allow feedback to contribute directly to the improvement of program management.

---

Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
  

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:
	82 FR 43035	09/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 5450	02/07/2018
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
America's PrepareAthon Customer Satisfaction Survey	FEMA Form 519-0-11	America's PrepareAthon Customer Satisfaction Survey
Customer Satisfaction Survey for FEMA Go
Customer Satisfaction Survey for the Sheltering and Temporary Essential Power Program	FEMA Form 519-0-42	Sheltering Temporary Essential Power (STEP) Survey (Script)
DisasterAssistance.gov Customer Satisfaction Survey	FEMA Form 519-0-17, FEMA Form 519-0-17, FEMA Form 519-0-17	Registration Intake (RI) DisasterAssistance.gov Customer Satisfaction Survey ,   General DisasterAssistance.gov Customer Satisfaction Survey ,   Applicant Inquiry (AI) DisasterAssistance.gov Customer Satisfaction Survey
Emergency Management Institute Course Evaluation Form	FEMA Form 092-0-3	Emergency Management Institute Course Evaluation Form
Emergency Management Institute Follow-up Evaluation Survey	FEMA Form 519-0-1	Emergency Management Institute Follow-up Evaluation Survey
FEMA GO Usability Survey	FEMA GO System Survey	FEMA GO Survey
FEMA National Continuity Stakeholder Survey	519-0-61	FEMA NCP Questionnaire
FEMA National Training and Education Division (NTED) Training Evaluation Level 1 Student "Reaction" Surveys for the Center for Domestic Preparedness (CDP) and Emergency Management Institute (EMI)	092-0-2, 092-0-3, 092-0-1	FIELD FORCE OPERATIONS (FFO) ,   COURSE EVALUATION FORM ,   CAMPUS SUPPORT AND FACILITIES
Fire is Everyone's Fight Initiative	FEMA Form 519-0-15	Fire is Everyone's Fight Initiative
Interactive Voice Response (IVR) Post-Call Satisfaction Survey	FEMA Form 519-0-57, FEMA Form 519-0-57S, FEMA Form 519-0-57, FEMA Form 519-0-57S	Interactive Voice Response Post Call Survey ,   Interactive Voice Response Post Call Survey Spanish Version ,   Interactive Voice Response Post Call Survey ,   Interactive Voice Response Post Call Survey Spanish Verion
Long Term Recovery (LTR) Survey Study	FF-104-FY-21-106, FF-104-FY-21-100, FF-104-FY-21-101, FF-104-FY-21-102, FF-104-FY-21-103, FF-104-FY-21-104, FF-104-FY-21-105, FF-1040FY-21-107	Long Term Recovery Survey - Restoration: 6 Months - Phone Questionnaire One ,   Long Term Recovery Survey - Restoration: 6 Months - Electronic Questionnaire One ,   Long Term Recovery Study - Reconstruction I: 12 Months - Phone Questionnaire Two ,   Long Term Recovery Study - Reconstruction I: 12 Months - Electronic Questionnaire Two ,   Long Term Recovery Study - Reconstruction I: 18 Months - Phone Questionnaire Three ,   Long Term Recovery Study - Reconstruction I: 18 Months - Electronic Questionnaire Three ,   Long Term Recovery Study - Reconstruction II: 24 Months - Phone Questionnaire Four ,   Long Term Recovery Study - Reconstruction II: 24 Months - Electronic Questionnaire Four
NFIP Customer Experience	FEMA Form 519-0-24	NFIP Customer Experience Survey
Online Survey Assessing Representatives of Organizations Serving Individuals with Limited English Proficiency Emergency Management Needs and Preferences	FEMA Form 519-0-13	Survey Questions for Organizations Serving Individuals with Limited English Proficiency (LEP)
Qualitative Feedback on U.S. Fire Administration's Analytical Reports	FEMA Form 519-0-2	Qualitative Feedback on U.S. Fire Administration's Analytical Reports

---

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	1,075,000	1,075,000	0	0	0	0
Annual Time Burden (Hours)	269,495	181,995	0	0	87,500	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:

---

Annual Cost to Federal Government: $2,079,000

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

---

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: 03/01/2018

---