Fast-Track Template CDRLF Satifaction Survey

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 3133-0188)
TITLE OF INFORMATION COLLECTION: CDRLF Satisfaction Survey
PURPOSE:
The National Credit Union Administration (NCUA) seeks feedback on the needs of low-income
designated credit unions (LICUs) regarding the services offered through the agency’s Office of
Credit Union Resources and Expansion (CURE). We are measuring overall and transactionrelated customer experience.
The survey is designed to measure the customer perspective after submitting grant/loan
applications, grant/loan agreements, reimbursement requests, and/or impact reports. The surveys
will be available online through CyberGrants. Respondents will receive a prompt to participate in
the survey after completing relevant actions in CyberGrants.
DESCRIPTION OF RESPONDENTS:
A survey will be issued to those credit unions designated as a LICU and have taken part of the
Community Development Revolving Loan Fund (CDRLF) program. Participation in the survey
will be voluntary. The membership of these organizations is comprised of credit unions that
serve low-income and underserved populations. CURE has contacts within these organizations
directly and through other contacts within the industry.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[ X ] Customer Satisfaction Survey
[ ] Small Discussion 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: _______________________________________
NCUA PRA Clearance Officer

Program Contact: Joshua Krantz, CURE
To assist review, please provide answers to the following question:

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Date: 01/08/2019

Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [ ] Yes [ X ] 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 [ X ] No
BURDEN HOURS
Category of Respondent
Private Sector – Low-Income
Designated Credit Unions
Totals

# Responses per
No. of
Respondents Respondent
273/year*
4**

Participation
Time
10 mins/0.17

Burden

273

182
182

* In the last three years, the average number of CDRLF awards provided to LICUs is 273.
**Each respondent will be presented with the same survey at each stage of the process. It is
estimated there are four stages: (1) applications; (2) agreement; (3) reimbursement, to (4) impact
report. For a total of 1,092 responses.
FEDERAL COST: The estimated annual cost to the Federal government is $1,500.
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: 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?
[ X ] 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?
The CDRLF program maintains a database of program applicants and participants online
in the CyberGrants system. The system allows CURE staff to easily produce reports on
participation in the CDRLF program and the accompanying survey.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[ X ] Web-based or other
[ ]
In-person
forms of Social Media
[ ]
Mail
[ ]
Telephone
[ ]
Other, Explain
2. Will interviewers or facilitators be used?

[ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the
request.

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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)
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.
Submit all instruments, instructions, and scripts are submitted with the request.

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