Fast Track Submission Form

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

TITLE OF INFORMATION COLLECTION: Immigration Legal Services for Afghan Arrivals Email Sign-Up Form

PURPOSE: Immigration Legal Services for Afghan Arrivals (ILSAA) is a service of the Office of Refugee Resettlement (ORR) within the Administration for Children and Families and is dedicated to providing new populations with the opportunity to achieve their full potential in the United States. ORR’s programs provide people in need with critical resources to assist them in becoming integrated members of American society. ILSAA provides immigration legal services to Eligible Arriving Afghans (EAAs) across the country and helps build the capacity of immigration legal service providers (LSPs). ILSAA is funded by ORR and implemented by the U.S. Committee for Refugees and Immigrants (USCRI) and ICF.

The ILSAA Email Sign-Up Form is designed for use by EAAs, and LSPs, to sign up for external messages, updates, and news, specifically in the form of welcome emails, e-newsletters, event invitations, new and updated resources, products, and trainings. It will allow us to better understand and improve our reach and service delivery and to collect information in a single location to make outreach more efficient and targeted.

DESCRIPTION OF RESPONDENTS:

Potential respondents include:

• Eligible Arriving Afghans, including Afghan humanitarian parolees, unaccompanied Afghan minors, or other Afghans with eligible status as defined in ORR Policy Letter 22-01.

• Legal Service Providers, including attorneys and paralegals, who provide immigration legal services to Afghan arrivals or who might be interested in providing immigration legal services to Afghan arrivals.

• Individuals from state and local entities and community-based organizations that provide support services or funding for support services for Afghan arrivals.

TYPE OF COLLECTION:

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X] Other: Sign-up Form

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: Joel Polanco, Support Services, Contracting Officer Representative (COR)

Administration for Children and Families (ACF), Office of Refugee

Resettlement

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

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [X] Yes [] 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

Information Collection	Category of Respondent	No. of Annual Respondents	No. of Responses per Respondent	Estimated Time per Response	Burden Hours
Immigration Legal Services for Afghan Arrivals Email Sign-Up Form	Individuals (Eligible Arriving Afghans)	22,928	1	0.017	389.78
	Individuals (Legal Service Providers)	320	1	0.017	5.44
	Individuals (Service Providers and/or funders from state and local entities)	133	1	0.017	2.26
Totals					398

FEDERAL COST: The estimated annual cost to the Federal government is: $10,120.28

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?

A link to this proposed E-mail Sign-Up Form will be made available on ILSAA’s website on the bottom of every webpage. Additionally, a link to this form will also be provided directly in outreach messaging, including in ILSAA’s monthly e-newsletter, in direct promotional e-mails to audiences, and through a QR code on the ILSAA flyer, and to anyone requesting to sign-up at webinars, events, or in ILSAA’s public-facing outreach e-mail box.

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:

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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