Fast Track Submission form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 3046-0048)

TITLE OF INFORMATION COLLECTION:

Website Satisfaction Survey

PURPOSE:

In Title VII of the Civil Rights Act of 1964, Congress expressly required the EEOC to engage in education and outreach activities, including providing training and technical assistance for those with rights and responsibilities under the employment discrimination laws enforced by the EEOC. EEOC’s efforts to provide education and outreach activities includes the use of digital technology to directly reach the EEOC’s varied and wide-ranging audiences. An important part of providing education through digital technologies is examining customers’ experiences with accessing information on the agency’s website. In order to obtain customers’ experiences with the website, the EEOC is implementing a website satisfaction survey on www.eeoc.gov.

DESCRIPTION OF RESPONDENTS:

Members of the public who access the EEOC’s website.

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:__Brett Brenner___________________________________________

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, 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	No. of Respondents	Participation Time	AnnualBurden
(1) Individuals or Households	1,173,472	2 minutes per response	39,116
Totals	1,173,472	2 minutes per response	39,116

FEDERAL COST: The estimated annual cost to the Federal government is based on the hourly rate of a GS 9 employee who dedicates 5% of labor hours, a GS 15 employee who dedicates 2% of labor hours, an SES employee who dedicates less than 1% of labor hours and the cost of materials/and or software.

Federal Cost Formula:

GS 9 employee hours spent on task (104) x employee pay rate ($33.28) =$3,461

GS 15 employee hours spent on task (42) x employee pay rate ($80) = $3,360

SES employee hours spent on task (21) x employee pay rate ($85) = $1,785

Software and/or materials = $15,000

Total Federal Cost $ = $23,606

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?

Website visitors will be asked if they would like to complete the questionnaire.

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

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ x ] No