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
Registration Form	Form	New	Repair queued
Incentive Form	Form	New	Repair queued
Form WPO Grantee Customer Satisfaction Survey - Instrument	Form	New	Repair queued
Form Consent Form for Individual Participants	Form	New	Repair queued
Focus Group Guide and Screener Form	Form	New	Repair queued
Survey	Form	New	Repair queued
Survey	Form	New	Repair queued
Survey	Form	New	Repair queued
Share Your ACS Data Story Form	Form	New	Repair queued
Share Your ACS Data Story for the American Community Survey (ACS) form	Form	New	Repair queued
Population and Housing Unit Estimates Special Tabulation Program Request Form	Form	New	Repair queued
Custom Tabulation Form	Form	New	Repair queued
Form Attachment A ACS Custom Tables Form	Form	New	Repair queued
Trade Mission Program Comprehensive Review Customer Satisfaction Survey	Form	New	Repair queued
MAPP Proposal Reviewer Survey	Form	New	Available
MAPP PI Survey	Form	New	Available
Event (Training, Webinar, Presentation, Workshop) Participant Evaluation Form	Form	New	Available
2020 NOAA IT Security and Privacy Virtual Conference Survey	Form	New	Available
BIS Public Health Industrial Base Survey (PHIB)	Form	New	Available
NOAA SST Longterm Timeseries Voluntary User Questionnaire	Form	New	Available
2020 Census CQA Consent Form	Form	New	Available
Generic Clearance Submission Template FINAL.doc	Supplementary Document	Uploaded 2017-06-16	Repair queued
0690.0030 Sup Stmt Part B 2020.docx	Supporting Statement B	Uploaded 2020-06-11	Available
0690.0030.SuppStmt.PartA 2020.docx	Supporting Statement A	Uploaded 2020-06-12	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260549	Focus Groups on Marketplace Transparency Tools in Gulf of Mexico IFQ Programs	Other-Questions	New
260518	Marine Recreational Information Program (MRIP) Data Quality Assessment Survey	Other-Assessment	New
260264	Trust & Safety Team's [email protected] Reporting	Other-Email	New
260068	PACIFEX23 Post-Exercise Survey	Other-Survey	New
259759	NWS Service Program Customer Satisfaction Surveys	Other-Survey	New
259294	2023 FedCASIC Post-Workshops Survey	Other-Survey	New
259251	eeBLUE Aquaculture Literacy Mini-grant Program Partner Survey	Other-Survey Questions	New
258507	BEA Website Customer Satisfaction Survey	Other-Survey	New
258492	Census Academy Customer Evaluation	Other-Email	New
258403	Greater Mississippi River Basin Spring Flood Outlook Webinars	Other-Survey	New
258025	NOAA Hiring Barriers Study, Faculty and Advisors	Other-Interview Questions	New
257443	Fifth National Climate Assessment Mid-Stream Participant Survey	Other-Survey	New
257344	NOAA Spectrum Pipeline Reallocation Engineering Study Follow-on (SPRES-FO) User Radio Frequency Interference Assessment Survey	Other-Survey	New
257202	Geostationary Operational Environmental Satellites (GOES) – R Series DataJam Application	Form	New	Registration Form
257201	Understanding Investment Challenges: Customer Feedback Survey on Investment Barriers to and from the United States	Other-Survey	New
256974	Market Research Study	Other-Guide Data Users	New
256904	DisMAP Customer Satisfaction and Usage Survey	Other-Survey	New
256838	QR Code usability testing: older adults	Form	New	Incentive Form
256838	QR Code usability testing: older adults	Other-Recruitment Flyer	New
256711	Focus Groups for Expanding Audiences, Removing Barriers, and Promoting Action on River and Flash Flood Risk	Other-Questions	New
256515	WPO Applicant Customer Experience and Satisfaction Survey	Other-Survey	New
256085	Meeting Request Questionnaire Forn	Other-Questionnaire	New
255899	NOAA Hiring Barriers Study Interviews	Other-Interview Questions	New
255839	Census.gov Refresh Usability Testing	Other-Enclosure 1	New
255771	US-Drought-Portal-Survey-Fall2022	Other-Survey	New
255770	NOAA Career Panel Exit Survey	Other-Survey	New
255760	World Magnetic Model Online Calculator API Registration and Feedback	Other-Survey	New
255490	EDA Build Back Better Regional Challenge Community of Practice Survey	Other-Survey	New
255346	Space Weather Prediction Testbed Pre/Post Workshop Questionnaires	Other-Questionnaire	New
255326	MED Week Registration	Other-Survey	New
255275	Department of Commerce Intern Customer Satisfaction Survey	Other-Survey	New
255010	CEDSCI Usability Evaluation	Other-Enclosure 1	New
254647	ESI Human-Use Data Collection User Survey	Other-Survey	New
254207	NOAA EPIC R2O/O2R Stakeholders Survey	Other-Survey	New
253952	2020 Census Group Quarters Enumeration Operation - Data Collection Feedback	Other-2020 Census Lessons Learned Template	New
253763	John A. Knauss Fellowship Program Surveys	Other-3. Survey and invitation/reminder emails	New
253716	Population Reference Bureau (PRB) and Census Bureau collection of feedback on activities and products to help data users access and use American Community Survey (ACS) data	Other-Survey	New
253714	World Magnetic Model Online Calculator API Registration and Feedback	Other-Intended Use Document	New
253253	NOAA Marine Debris Program Education Newsletter	Other-Newsletter Poll Questions	New
252913	NWS Drought Messaging Focus Groups	Other-Questions	New
252894	HPS Tool Usability Evaluation	Other-Recuitment Flyer	New
252703	Data.census.gov User Satisfaction Questionnaire	Other-Survey	New
252699	2022 FedCASIC Post-Workshops Survey	Other-Survey	New
252425	U.S. Census Bureau - collection of data user feedback on the Disclosure Avoidance (DA) Handbook	Other-Handbook Survey	New
252221	NOAA Watershed STEM Education Partnership Grants Program: Meaningful Watershed Educational Experiences (MWEE) Youth Focus Group Protocol	Other-Protocol	New
252220	NOAA Watershed STEM Education Partnership Grants Program: Meaningful Watershed Educational Experiences (MWEE)	Other-Survey	New
251906	Population Reference Bureau (PRB) and Census Bureau collection of information about data user applications of the 2020 ACS 1-Year Experimental Data	Other-Email	New
251615	Transition Experience Survey	Other-Survey	New
251338	NOAA National Climate Assessment Workshop Evaluation	Other-Evaluation Questions	New
251315	NOAA Enterprise Cloud Services Customer Satisfaction Survey	Other-Survey	New
251314	NOAA N-Wave Customer Survey	Other-Survey	New
251261	QR Code usability testing for mobile surveys	Other-Enclosure 1	New
251231	Survey Tool for Employing Rhetoric to Improve Probabilistic Forecast Communication	Other-Survey	New
251140	NOAA Customer Experience (CX) External Customer Survey	Other-Survey	New
250575	Department of Commerce, Enterprise Services-Acquisition Government and Business Exchange (GABE) Pilot Program	Other-Questionnaire	New
250434	NOAA Customer Experience (CX) External Customer Focus Groups	Other-Focus Group Questions	New
250432	NOAA Customer Experience (CX) External Customer Focus Groups	Other-Focus Group Questions	New
250382	Hurricane Ida National Service Assessment External Partner Feedback	Other-Survey	New
249893	R&D HPC User Survey	Other-Survey Questions	New
249884	Planning Database (census.gov) User Feedback Survey	Other-PDB User Feedback Survey Questions	New
249883	WPO Grantee Customer Satisfaction Survey	Form	New	WPO Grantee Customer Satisfaction Survey - Instrument
249879	Census.gov Refresh	Form	New	Consent Form for Individual Participants
249879	Census.gov Refresh	Other-Protocol	New
249586	NOAA Workshop on Leveraging AI in Environmental Sciences Questionnaire	Other-Survey	New
249571	Market Research Study	Form	New	Focus Group Guide and Screener Form
249273	NOAA IT Customer Satisfaction Surveys	Other-Survey	New
249006	Marine Debris Program Grant Applicant Customer Feedback	Other-Survey	New
248960	Survey on the Collaborative Forecast Process for Precipitation Forecasts	Other-Survey	New
248919	20XX NOAA Environmental Data Management Workshop (EDMW) - Questionnaire	Other-Questionnaire	New
248867	2020 Census Community Partnership and Engagement Program (CPEP) Survey Questionnaire	Other-Survey Sample Description	New
248820	NWS Safety Climate Survey	Other-Survey	New
248811	2020 Census Community Partnership & Engagement Program Small Discussion Group	Other-Survey Sample	New
248472	NESDIS G-DCS User Assessment Survey	Other-Survey	New
248115	Office for Coastal Management Digital Coast Academy Level 3 Training Evaluation	Other-Survey	New
248112	EDA Revolving Loan Fund (RLF) Recipient Reporting Experience 2 / RLF Portal Login Support & Technology Readiness Assessment	Other-Login Assessment Survey	New
248024	Atmospheric River Frequency Forecasts User Survey	Form	New	Survey
248023	NESDIS Internal Website Short Survey	Form	New	Survey
247335	Geostationary Operational Environmental Satellites (GOES) – R Series Hackathon Application	Other-Application	New
246898	Trademarks Authenticated Login Usability Testing	Other-Discussion Guide	New
246897	Deepwater Horizon Natural Resources Damage Assessment (NRDA) Open Ocean Trustee Implementation Group public webinar	Other-Poll Questions	New
246682	Participatory Geographic Information System Survey	Instruction	New
246223	NOAA OCIO Supply Chain Risk Management (SCRM) Team Survey	Form	New	Survey
246182	Share Your ACS Data Story for American Community Survey (ACS) data.	Form	New	Share Your ACS Data Story Form
246182	Share Your ACS Data Story for American Community Survey (ACS) data.	Form	New	Share Your ACS Data Story for the American Community Survey (ACS) form
246179	Automated Request Form for the Population and Housing Unit Estimates Special Tabulation Program	Form	New	Population and Housing Unit Estimates Special Tabulation Program Request Form
246163	Custom Tables Request Form for American Community Survey data products already available on data.census.gov	Form	New	Custom Tabulation Form
246163	Custom Tables Request Form for American Community Survey data products already available on data.census.gov	Form	New	ACS Custom Tables Form
246085	Census Bureau Mortality Studies Workshop Post Evaluation Survey	Other-Survey Questions	New
245965	NOAA OCIO CDO Customer Experience Survey	Other-Survey	New
245824	NOAA SURFRAD User Survey	Other-Survey	New
245554	Survey Questionnaire for 2020 Census Integrated Partnerships and Communications (IPC) Lessons Learned from National Partners	Other-Survey Questionnaire	New
245543	Interviews for 2020 Census Integrated Partnerships and Communications (IPC) Lessons Learned from National Partners	Other-Interview Guide	New
245444	NOAA Voices Oral History Archive User Satisfaction Survey	Other-Narrator Feedback	New
245361	In-Depth Interviews for USCB Digital Persona Development	Other-Discussion Guide	New
245310	Trade Mission Program Comprehensive Review Customer Satisfaction Survey	Form	New	Trade Mission Program Comprehensive Review Customer Satisfaction Survey
244752	NOAA Climate Program Office MAPP Stakeholder Surveys	Form	New	MAPP Proposal Reviewer Survey
244752	NOAA Climate Program Office MAPP Stakeholder Surveys	Form	New	MAPP PI Survey
244518	Stakeholder Engagement for Standard Application Process	Other-Sample Email	New
244470	Event (Training, Webinar, Presentation, Workshop) Participant Evaluation Form	Form	New	Event (Training, Webinar, Presentation, Workshop) Participant Evaluation Form
244469	NOAA 2020 IT Security & Privacy Virtual Conference Customer Survey	Form	New	2020 NOAA IT Security and Privacy Virtual Conference Survey
244323	NIST MEP Tab Wilkins Emerging Leaders Program Survey	Other-Survey	New
244319	NOAA Cyber Security Division (CSD) Customer Survey	Other-Survey	New
244317	NOAA Libraries: Usefulness and Quality of Services and Collections Fast Track Request	Other-Survey	New
244315	EDA Grantee Customer Satisfaction Survey	Other-Survey	New
244314	EDA Applicant Customer Satisfaction Survey	Other-Survey	New
244193	BIS Public Health Industrial Base Survey (PHIB).	Form	New	BIS Public Health Industrial Base Survey (PHIB)
244104	STAR/NCEI Sea Surface Temperature (SST) User Needs Survey	Form	New	NOAA SST Longterm Timeseries Voluntary User Questionnaire
243551	Survey Questionnaire for 2020 Census Integrated Partnership and Communications (IPC) Lessons Learned	Other-Survey Questionnaire	New
243549	GOES DCS & HRIT/EMWIN User Assessment	Other-User Assessment	New
243548	2020 NOAA Environmental Data Management Workshop (EDMW) - Questionnaire	Other-Questionnaire	New
243445	CQA Debriefing Focus Groups	Form	New	2020 Census CQA Consent Form
243445	CQA Debriefing Focus Groups	Other-Moderator Guide	New
243271	Data.census.gov User Satisfaction Questionnaire	Other-Survey	New
243270	BIS Educational Seminars Survey	Other-Survey	New
243201	Davidson Fellowship Program	Other-Survey	New
243199	World Magnetic Model User Survey	Other-Survey	New
243180	NOAA National Marine Sanctuaries Veteran Survey 2020	Other-Survey	New
242817	EDA Revolving Loan Fund (RLF) Recipient Reporting Experience	Other-Survey	New

ICR Details

OMB Control No: 0690-0030	ICR Reference No: 202006-0690-002
Status: Historical Active	Previous ICR Reference No: 201705-0690-001
Agency/Subagency: DOC/OS	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/23/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/12/2020
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	244,710	0	244,710
Time Burden (Hours)	75,711	0	75,711
Cost Burden (Dollars)	0	0	0

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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.

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Authorizing Statute(s): None

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:
	85 FR 16612	03/24/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 35257	06/09/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 112

table that charts list of burden

IC Title	Form No.	Form Name
2020 Census Community Partnership & Engagement Program Small Discussion Group
2020 Census Community Partnership and Engagement Program (CPEP) Survey Questionnaire
2020 Census Group Quarters Enumeration Operation - Data Collection Feedback
2020 NOAA Environmental Data Management Workshop (EDMW) - Questionnaire
2022 FedCASIC Post-Workshops Survey
2023 FedCASIC Post-Workshops Survey
20XX NOAA Environmental Data Management Workshop (EDMW) - Questionnaire
Atmospheric River Frequency Forecasts User Survey	None	Survey
Automated Request Form for the Population and Housing Unit Estimates Special Tabulation Program	None	Population and Housing Unit Estimates Special Tabulation Program Request Form
BEA Website Customer Satisfaction Survey
BIS Educational Seminars Survey
BIS Public Health Industrial Base Survey (PHIB).	NA	BIS Public Health Industrial Base Survey (PHIB)
CEDSCI Usability Evaluation
CQA Debriefing Focus Groups	NA	2020 Census CQA Consent Form
Census Academy Customer Evaluation
Census Bureau Mortality Studies Workshop Post Evaluation Survey
Census.gov Refresh		Consent Form for Individual Participants
Census.gov Refresh Usability Testing
Custom Tables Request Form for American Community Survey data products already available on data.census.gov	Attachment A, None	ACS Custom Tables Form ,   Custom Tabulation Form
Data.census.gov User Satisfaction Questionnaire
Data.census.gov User Satisfaction Questionnaire
Davidson Fellowship Program
Deepwater Horizon Natural Resources Damage Assessment (NRDA) Open Ocean Trustee Implementation Group public webinar
Department of Commerce Intern Customer Satisfaction Survey
Department of Commerce, Enterprise Services-Acquisition Government and Business Exchange (GABE) Pilot Program
DisMAP Customer Satisfaction and Usage Survey
EDA Applicant Customer Satisfaction Survey
EDA Build Back Better Regional Challenge Community of Practice Survey
EDA Grantee Customer Satisfaction Survey
EDA Revolving Loan Fund (RLF) Recipient Reporting Experience
EDA Revolving Loan Fund (RLF) Recipient Reporting Experience 2 / RLF Portal Login Support & Technology Readiness Assessment
ESI Human-Use Data Collection User Survey
Event (Training, Webinar, Presentation, Workshop) Participant Evaluation Form	None	Event (Training, Webinar, Presentation, Workshop) Participant Evaluation Form
Fifth National Climate Assessment Mid-Stream Participant Survey
Focus Groups for Expanding Audiences, Removing Barriers, and Promoting Action on River and Flash Flood Risk
Focus Groups on Marketplace Transparency Tools in Gulf of Mexico IFQ Programs
GOES DCS & HRIT/EMWIN User Assessment
Geostationary Operational Environmental Satellites (GOES) – R Series DataJam Application	none	Registration Form
Geostationary Operational Environmental Satellites (GOES) – R Series Hackathon Application
Greater Mississippi River Basin Spring Flood Outlook Webinars
HPS Tool Usability Evaluation
Hurricane Ida National Service Assessment External Partner Feedback
In-Depth Interviews for USCB Digital Persona Development
Interviews for 2020 Census Integrated Partnerships and Communications (IPC) Lessons Learned from National Partners
John A. Knauss Fellowship Program Surveys
MED Week Registration
Marine Debris Program Grant Applicant Customer Feedback
Marine Recreational Information Program (MRIP) Data Quality Assessment Survey
Market Research Study	None	Focus Group Guide and Screener Form
Market Research Study
Meeting Request Questionnaire Forn
NESDIS G-DCS User Assessment Survey
NESDIS Internal Website Short Survey	None	Survey
NIST MEP Tab Wilkins Emerging Leaders Program Survey
NOAA 2020 IT Security & Privacy Virtual Conference Customer Survey	None	2020 NOAA IT Security and Privacy Virtual Conference Survey
NOAA Career Panel Exit Survey
NOAA Climate Program Office MAPP Stakeholder Surveys	None, None	MAPP PI Survey ,   MAPP Proposal Reviewer Survey
NOAA Customer Experience (CX) External Customer Focus Groups
NOAA Customer Experience (CX) External Customer Focus Groups
NOAA Customer Experience (CX) External Customer Survey
NOAA Cyber Security Division (CSD) Customer Survey
NOAA EPIC R2O/O2R Stakeholders Survey
NOAA Enterprise Cloud Services Customer Satisfaction Survey
NOAA Hiring Barriers Study Interviews
NOAA Hiring Barriers Study, Faculty and Advisors
NOAA IT Customer Satisfaction Surveys
NOAA Libraries: Usefulness and Quality of Services and Collections Fast Track Request
NOAA Marine Debris Program Education Newsletter
NOAA N-Wave Customer Survey
NOAA National Climate Assessment Workshop Evaluation
NOAA National Marine Sanctuaries Veteran Survey 2020
NOAA OCIO CDO Customer Experience Survey
NOAA OCIO Supply Chain Risk Management (SCRM) Team Survey	None	Survey
NOAA SURFRAD User Survey
NOAA Spectrum Pipeline Reallocation Engineering Study Follow-on (SPRES-FO) User Radio Frequency Interference Assessment Survey
NOAA Voices Oral History Archive User Satisfaction Survey
NOAA Watershed STEM Education Partnership Grants Program: Meaningful Watershed Educational Experiences (MWEE)
NOAA Watershed STEM Education Partnership Grants Program: Meaningful Watershed Educational Experiences (MWEE) Youth Focus Group Protocol
NOAA Workshop on Leveraging AI in Environmental Sciences Questionnaire
NWS Drought Messaging Focus Groups
NWS Safety Climate Survey
NWS Service Program Customer Satisfaction Surveys
Office for Coastal Management Digital Coast Academy Level 3 Training Evaluation
PACIFEX23 Post-Exercise Survey
Participatory Geographic Information System Survey
Planning Database (census.gov) User Feedback Survey
Population Reference Bureau (PRB) and Census Bureau collection of feedback on activities and products to help data users access and use American Community Survey (ACS) data
Population Reference Bureau (PRB) and Census Bureau collection of information about data user applications of the 2020 ACS 1-Year Experimental Data
QR Code usability testing for mobile surveys
QR Code usability testing: older adults	none	Incentive Form
R&D HPC User Survey
STAR/NCEI Sea Surface Temperature (SST) User Needs Survey	None	NOAA SST Longterm Timeseries Voluntary User Questionnaire
Share Your ACS Data Story for American Community Survey (ACS) data.	None, None	Share Your ACS Data Story for the American Community Survey (ACS) form ,   Share Your ACS Data Story Form
Space Weather Prediction Testbed Pre/Post Workshop Questionnaires
Stakeholder Engagement for Standard Application Process
Survey Questionnaire for 2020 Census Integrated Partnership and Communications (IPC) Lessons Learned
Survey Questionnaire for 2020 Census Integrated Partnerships and Communications (IPC) Lessons Learned from National Partners
Survey Tool for Employing Rhetoric to Improve Probabilistic Forecast Communication
Survey on the Collaborative Forecast Process for Precipitation Forecasts
Trade Mission Program Comprehensive Review Customer Satisfaction Survey	None	Trade Mission Program Comprehensive Review Customer Satisfaction Survey
Trademarks Authenticated Login Usability Testing
Transition Experience Survey
Trust & Safety Team's [email protected] Reporting
U.S. Census Bureau - collection of data user feedback on the Disclosure Avoidance (DA) Handbook
US-Drought-Portal-Survey-Fall2022
Understanding Investment Challenges: Customer Feedback Survey on Investment Barriers to and from the United States
WPO Applicant Customer Experience and Satisfaction Survey
WPO Grantee Customer Satisfaction Survey		WPO Grantee Customer Satisfaction Survey - Instrument
World Magnetic Model Online Calculator API Registration and Feedback
World Magnetic Model Online Calculator API Registration and Feedback
World Magnetic Model User Survey
eeBLUE Aquaculture Literacy Mini-grant Program Partner 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	244,710	244,710	0	-141,900	141,900	0
Annual Time Burden (Hours)	75,711	75,711	0	-31,848	31,848	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Based on the actual use of burden hours during the previous approval period and the number of respondents involved, we have adjusted (decreased) the number of respondents and burden hours. Accordingly, we have also adjusted the estimated cost to the public.

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Annual Cost to Federal Government: $26,689

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.     Yes

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? No

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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: 06/12/2020

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