Generic Clearance Submission Template

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648, exp. date 5/31/2021)



TITLE OF INFORMATION COLLECTION: NLM NCBI 2018 Population Frequency Data Survey

PURPOSE:  
The goal of this National Library of Medicine (NLM) survey is to collect qualitative customer service delivery feedback from users of the National Center for Biotechnology Information (NCBI) human variation resources on their needs for summary population frequency data. The survey consists of a short list of questions about how they are using frequency data and how we can improve the NCBI presentation of this data.  The information from this survey will be used to improve the data presented on the NCBI variation web pages.  

DESCRIPTION OF RESPONDENTS: 
Respondents will be individuals who voluntarily provide feedback via a link to complete the survey on human population frequency data.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form 	[X] 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: Barton Trawick, PhD_____________________________________________

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

Personally Identifiable Information:
    1. Is personally identifiable information (PII) collected?  [  ] Yes  [ X ]  No 
    2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974?   [  ] Yes [ X ] No   
    3. If Applicable, has a System or Records Notice been published?  [  ] Yes  [  ] No [ X ] N/A


Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants?  [  ] Yes [X] No  


ESTIMATED BURDEN HOURS and COSTS 

Category of Respondent 
No. of Respondents
No. of Responses per Respondent 
Time per 
Response 
(in hours) 
Total Burden
Hours 
Individuals or Households
    350
    
      1 
      
    4/60
    
  23
   





Totals
    350
    350

  23 hrs.


 Category of Respondent

Total Burden
Hours
Wage Rate*
Total Burden Cost 
Individuals or Households
     23
   $24.34
 $559.82

   


Totals
    183

 $559.82


*The General Public wage rate was obtained from https://www.bls.gov/oes/2017/may/oes_nat.htm#00-0000

FEDERAL COST:  The estimated annual cost to the Federal government is: $559.82.
                      

 Staff

Grade/Step
Salary
% of Effort
Fringe (if applicable)
Total Cost to Gov’t
Federal Oversight





Staff scientist
  T42
$138,329
1%

   $1,383.29












Contractor Cost




       N/A






Travel




      N/A
Other Cost




      N/A






Total




  $1383.29

*The Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/18Tables/html/DCB.aspx


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	[X] 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?

Respondents will be individuals who voluntarily agree to provide feedback on human population frequency data.

Administration of the Instrument
    1. How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media 
[  ] Telephone	
[  ] In-person	
[  ] Mail 
[X ] Other, Explain:  Email link to the survey
    2. Will interviewers or facilitators be used?  [  ] Yes [ X ] No