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pdfOMB Control No.: 3095-0070
Expiration date: 01-31-2024
Request for Approval under the
“Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”
(OMB Control Number: 3095-0070)
TITLE OF INFORMATION COLLECTION: An American Symbol Forged from the
Progressive Era: The National Archives National Historic Landmark Study
DATE OF REQUEST: 3/26/2021
PURPOSE: To register participants for a presentation, “An American Symbol Forged from the
Progressive Era: The National Archives National Historic Landmark Study”
DESCRIPTION OF RESPONDENTS: Members of the historic community, staff at the
National Park Service, staff at the National Archives, and any other interested participants.
TYPE OF COLLECTION: (Check one)
☐ C ustom er C om m ent C ard/C om plaint Form
☐ U sability T esting (e.g.,W ebsite or Softw are)
☐ Focus G roup
presentation
☐ C ustom er Satisfaction Survey
☐ Sm all D iscussion G roup
x Other: emails for Google Meets
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: Jessie Kratz
Page 1 of 4
NA Form 2023 (09-17)
Required by NARA 108
To assist review, please provide answers to the following question:
OMB Control No.: 3095-0070
Expiration date: 01-31-2024
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? x Yes ☐ N o
2. If Yes, will any information that is collected be included in records that are subject to the
Privacy Act of 1974? ☐ Y es x No
3. If Yes, has an up-to-date System of Records Notice (SORN) been published? ☐ Y es x No
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? ☐ Y es x N o
BURDEN HOURS
Category of Respondent
Participation
Time
1 minute
Burden
Individuals and households
No. of
Respondents
75
Federal government
175
1 minute
3
1 minute
4
Totals
250
FEDERAL COST: The estimated annual cost to the Federal Government is $0
1
.
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?
x Yes ☐ N o
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?
We will share the link with the historical community, staff at the National Park Service,
and NARA staff and encourage them to share with anyone who they think would be interested in
attending the presentation.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
x Web-based or other forms of Social Media (if applicable, please add url)
☐ T elephone
☐ In-person
☐ M ail
☐ O ther,E xplain
2. Will interviewers or facilitators be used? ☐ Y es x No
3. Length of Collection: From: ASAP To: April 29, 2021
Page 2 of 4
NA Form 2023 (09-17)
Required by NARA 108
OMB Control No.: 3095-0070
Expiration date: 01-31-2024
Please make sure that all instruments, instructions, and scripts are submitted with the
request.
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)
DATE OF REQUEST: Enter the date the request is made.
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. Enter the date span “from” and “to” that this survey
will be administered.
Submit all instruments, instructions, and scripts with the request.
Page 3 of 4
NA Form 2023 (09-17)
Required by NARA 108
OMB Control No.: 3095-0070
Expiration date: 01-31-2024
An American Symbol Forged from the Progressive Era: The National Archives National
Historic Landmark Study
Please join the National Park Service and the National Archives History Office to learn how the
National Archives became an architectural symbol of the core values of American democracy,
how it was forged over many decades from the values and methods of Progressive-Era
government reformers, and how architect John Russell Pope and his contemporaries created an
exceptional example of American Classical art and architecture ideally suited to reflect the
mission and meaning of the institution.
Led by historian Dr. Steven Bedford, the presentation will focus on the National Archives
Building's national significance and the recently completed National Historic Landmark (NHL)
study. Dr. Bedford is author of John Russell Pope, Architect of Empire and director of historic
preservation for WSP USA. National Park Service historian and NHL Program Coordinator,
Kathryn Smith will introduce the project and the NHL program. The illustrated presentation will
be followed by a question and answer session.
Join us on Thursday, April 29, 2021 at Noon (ET) for an illuminating discussion of the National
Archives' exceptional place in United States History. Registration is required and will be limited
to 250 participants. Click here to register. [This will link to a form where we ask their name,
affiliation, and email address]
The form should say: To register for An American Symbol Forged from the Progressive Era:
The National Archives National Historic Landmark Study, a virtual program to be held at noon
(ET) on Thursday, April 29, 2021, please provide the following information:
Name [optional]
Affiliation [optional]
Email address [required]
You will receive an email confirmation with login instructions within a couple of days of
completing your registration. If you have any questions, please contact Jessie Kratz, National
Archives Historian, at [email protected]. Thank you.
Page 4 of 4
NA Form 2023 (09-17)
Required by NARA 108
File Type | application/pdf |
Author | 558022 |
File Modified | 2021-03-29 |
File Created | 2021-03-29 |