FastTrack GenIC Submission Form -ANA Application Submission Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Administration for Native Americans (ANA) Application Submission Survey

PURPOSE: The Administration for Native Americans (ANA) would like to learn more about applicants’ experiences with ANA’s funding opportunity announcement (FOA) application and submission processes. Data collected from the proposed surveys will be used to help ANA to develop future FOAs and update processes for applying to an announcement.

While most of the questions request feedback related to any 2021 ANA FOA, there is a subset of questions specific to the Social and Economic Development Strategies – Growing Organizations (SEDS-GO) funding opportunity. The survey includes skip patterns for these questions.

DESCRIPTION OF RESPONDENTS: Respondents will include individuals involved in the submission of one or more application(s) in response to 2021 ANA FOAs. For example: project staff, contractors and grant writers.

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: Amy Zukowski, ACF Administration for Native Americans

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	Burden
ANA’s Application Submission Survey	250	10 minutes	41.66 hours
Totals	250	10 minutes	41.66 hours

FEDERAL COST: The estimated annual cost to the Federal government is $160

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 [ ] 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?

ANA defines the number of potential respondents as organizations who submitted applications in one of the five 2021 ANA Funding Opportunities. The survey will be deployed after each of two to three application review panel sessions.

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

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