Fast Track Submission Form

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

T ITLE OF INFORMATION COLLECTION: Healthy Marriage and Responsible Fatherhood (HMRF) Grant Recipient Support and Advancement interest Survey

PURPOSE: The Office of Family Assistance (OFA), an Office of the Administration for Children & Families (ACF) is gathering information from grant recipients about potential training and technical assistance (TTA) topics that will be provided during the current grant cycle. The purpose of this information is to find out which topics are of most interest and use in supporting and advancing grant recipient effectiveness and impact.

DESCRIPTION OF RESPONDENTS: Survey respondents will be the 206 HMRF Project Directors and/or Project Managers for organizations that received federal funding for their HMRF projects.

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:________________________________________________

Meghan Heffron, Training and Tech Transfer Branch Chief, Office of Family Assistance, Administration for Children and Families. (202) 401-6619, [email protected]

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 [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] 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
Individuals who are project directors or project managers of organizations that received federal HMRF grants	206	5 minutes	17.2 hours
Totals

FEDERAL COST: The estimated annual cost to the Federal government is $664.26¹

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?

All HMRF project directors and project managers are eligible to respond to the participant feedback. This amounts to 206 potential contacts who may respond to the feedback instrument delivered via email.

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

1 This number is based upon average weekly salary for those holding a B.A. degree. U.S. Department of Labor, Bureau of Labor Statistics. (2023, January 19). https://www.bls.gov/news.release/pdf/wkyeng.pdf The hourly calculation was $38.68 per hour.

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