EBSA “Lost & Found Portal” Collection 1: Design Review

Generic Clearance Submission Template (1225-0059) EBSA Lost and Found (003).docx

Department of Labor Generic Clearance for Outreach Activities

EBSA “Lost & Found Portal” Collection 1: Design Review

OMB: 1225-0059

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Request for Approval under the “Department of Labor Generic Clearance for Outreach Activities”

(OMB Control Number: 1225-0059)

Shape1 TITLE OF INFORMATION COLLECTION: EBSA “Lost & Found Portal” Collection 1: Design Review


PURPOSE: The purpose of this collection is to get public feedback on the web portal at every stage of its creation, and to follow the TMF board’s order to involve the public in the whole project. This will ensure the portal meets the end users’ needs and goals, is accessible, and offers a frictionless, enjoyable digital experience.



DESCRIPTION OF RESPONDENTS: Members of the public aged 30 and over who have held at least two jobs where the employer provided retirement benefits.



TYPE OF COLLECTION: (Check one)


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

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

[X] 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:__Sara Reiss__________________________________


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, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [X] No


Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [X] Yes [ ] No


BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

Individuals or Households

12

45 minutes on average

9 hours

Individuals or Households

500

15 minutes on average

125 hours

Totals

512

1 hour, on average


134

hours



FEDERAL COST: The estimated annual cost to the Federal government is $20,067.84. This estimate is based on agency staff spending approximately 264 hours each year reviewing inquiries. The cost is based on GS-14 Step 5 and GS-15 Step 6 pay. See “Salary Table 2023-DCB Incorporating the 4.1% General Schedule Increase and a Locality Payment of 32.49% For the Locality Pay Area of Washington-Baltimore-Arlington, DC-MD-VA-WV-PA",” available at https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2023/DCB_h.pdf (last accessed Nov. 2023).


Staff Level

Hourly Rate

Hours/ Month

Hours/ Year

Cost/Year

GS-14 Step 5

$71.88

16

192

$13,800.96

GS-15 Step 6

$87.04

6

72

$6,266.88

Total

 

22

264

$20,067.84



The selection of your targeted respondents

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?

See attached sampling plan.


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


  1. Will interviewers or facilitators be used? [ X ] Yes [ ] No

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

Instructions for completing Request for Approval under the “Generic Clearance for Outreach Activities”


Shape2

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on XXXXX)


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


Personally Identifiable Information: Provide answers to the questions.


Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.


Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.


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


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2024-07-31

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