Survey of Airman Satisfaction with Aeromedical Certification Services

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2120-0707 Survey of Airman Satisfaction with Aeromedical Certification Services	Form	Modified	Available
Status of Privacy Assessment_5.1.19.docx	Supplementary Document	Uploaded 2019-05-01	Available
2016 Airman Survey OVERALL Report with TEXT appendices A-C.pdf	Supplementary Document	Uploaded 2019-05-01	Available
2018 Airman INVITATION EMAIL.docx	Supplementary Document	Uploaded 2019-04-25	Available
Government Performance and Results Act of 1993.pdf	Supplementary Document	Uploaded 2019-04-25	Available
Executive Order No. 12862.pdf	Supplementary Document	Uploaded 2019-04-25	Available
April USE_AMCS Airman 2014 Feedback Survey Results_FASMT - Current.pptx	Supplementary Document	Uploaded 2015-06-29	Available
2014 AMCS Pilot overall Report NO text Final Appendices A-B.pdf	Supplementary Document	Uploaded 2015-06-29	Available
2018 Airman 4th Reminder FULL Paper SVY FINAL.docx	Supplementary Document	Uploaded 2019-04-25	Available
2018 Airman 1st REMINDER EMAIL.docx	Supplementary Document	Uploaded 2019-04-25	Repair queued
2120-0707 Supporting Statement Part B 04 25 2019.docx	Supporting Statement B	Uploaded 2019-04-25	Available
2120-0707 Supporting Statement A 02 08 2019 for PART B Review 5.1.2019.docx	Supporting Statement A	Uploaded 2019-05-01	Available
2018 Airman Email Notification.docx	Supplementary Document	Uploaded 2019-04-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
25872	Survey of Airman Satisfaction with Aeromedical Certification Services	Form	Modified

ICR Details

OMB Control No: 2120-0707	ICR Reference No: 201904-2120-007
Status: Active	Previous ICR Reference No: 201506-2120-004
Agency/Subagency: DOT/FAA	Agency Tracking No:
Title: Survey of Airman Satisfaction with Aeromedical Certification Services
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: 11/26/2019
	Date Received in OIRA: 05/07/2019
Terms of Clearance: Prior to resubmission, the agency should ensure that URLs to surveys use .gov top-level domains.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	11/30/2019
Responses	2,323	0	2,333
Time Burden (Hours)	581	0	584
Cost Burden (Dollars)	0	0	0

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Abstract: • The survey will be available for completion either electronically or hard copy • The collection is reported by survey and is voluntary • Airmen who have sought a medical certification within two years of the survey administration will be invited to participate in the survey • The survey will take place approximately every two years • The survey will be administered by the Human Factors Research Lab of the Civil Aerospace Medical Institute with the support of Cherokee CRC, LLC. • Demographic information will be collected from respondents, but any information disseminated to the public will be presented in aggregate form • The information obtained from the survey will be used to brief the Federal Air Surgeon, the Regional Flight Surgeons, and the Director of the Civil Aerospace Medical Institute following the survey closing • Data will be used by the senior managers of OAM to: o Evaluate stakeholder satisfaction with aeromedical certification services provided by or on behalf of the FAA o Identify areas in which improvements in service delivery can be made o Assess changes in stakeholder satisfaction as a result of those improvements • All publications of data would be provided in a technical report or journal article • The information from the survey will also be briefed in the Federal Air Surgeon’s Medical Bulletin • It is anticipated that the information collected will be disseminated to the public or used to support publicly disseminated information. As explained in the preceding paragraphs, the information gathered has utility. The Office of Aerospace Medicine will retain control over the information and safeguard it from improper access, modification, and destruction, consistent with OAM standards for privacy of information. See response to Question 10 of this Supporting Statement for more information on the OAM guarantee of privacy. Prior to dissemination, the information will be subjected to quality control measures and a pre-dissemination review pursuant to Section 515 of Public Law 106-554.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 1265	02/01/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 16929	04/23/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Survey of Airman Satisfaction with Aeromedical Certification Services	2120-0707	FAA Aerospace Medical Certification Services Pilot Satisfaction Survey

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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	2,323	2,333	0	0	-10	0
Annual Time Burden (Hours)	581	584	0	0	-3	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: • The reason for administering the survey is to capture trend data and use feedback to improve organizational operations. • The population of interest has been updated since the last administration and is reflected in the burden estimate and number of respondents.

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Annual Cost to Federal Government: $33,000

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.     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

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Common Form ICR:  No

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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: 05/07/2019

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