FastTrack GenIC Submission Form - National Responsible Fatherhood Clearinghouse (NRFC) 2021 Virtual Event Feedback Surveys

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

TITLE OF INFORMATION COLLECTION: National Responsible Fatherhood Clearinghouse (NRFC) 2021 Virtual Event Feedback Surveys

PURPOSE: This information collection is intended to determine the extent to which participants were satisfied with the NRFC 2021 Virtual Event. The event titled, Leading with Compassion: Understanding and Serving Low-Income Fathers in a Changing World, is a 1.5-day virtual event focused on the circumstances and needs of low-income fathers.

Participants will be given the opportunity to respond to an invitation to voluntarily submit feedback about the event, including the agenda, logistics, and the event website. The information that we collect will inform planning for future events.

DESCRIPTION OF RESPONDENTS: Intended respondents are members of the public participating in the virtual event via the event website.

TYPE OF COLLECTION:

[ ] 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 primary purpose of the results is not for public dissemination.

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 and affiliation: Jacqueline Proctor, Family Assistance Program Specialist, Office of Family Assistance

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

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

Information Collection	Category of Respondent	No. of Respondents	No. of Responses per Respondent	Estimated Time per Response	Burden Hours
NRFC 2021 Virtual Event Participant Feedback Form	Event Participants	250	1	10 minutes	41.7 hours
NRFC 2021 Session Feedback Form	Event Participants	250	7	5 minutes	145.8
Totals		250	8	Avg. 5.64 minutes	188 hours

FEDERAL COST: The estimated annual cost to the Federal government is $11,107.72.

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?

The universe of potential respondents includes event registrants who will all be invited to provide feedback on the event overall, including the agenda, logistics, the event website.

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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