IDAS survey fast track form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2700-0153)

TITLE OF INFORMATION COLLECTION: IDAS Team Meeting Feedback Form

PURPOSE: IDAS civil servants and contractors will utilize this form to share their thoughts, questions, shout outs/recognitions about the organization’s all hands team meeting. Their input will be submitted anonymously.

DESCRIPTION OF RESPONDENTS: IDAS Civil Servants and Contractors

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: Victoria Hatcher

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

Category of Respondent	No. of Respondents	Participation Time	Burden
NASA contractors and civil servants internal to IDAS	75	5 mins
Totals	75	5 mins/ea	6.25 hrs

FEDERAL COST: The estimated annual cost to the Federal government is $30/hr x 6.25 = $187.50.

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?

This form will be completed by IDAS civil servants and contractors. The link will be shared through Teams meeting chat during the meeting and in the IDAS Teams channel.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, explain _________

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

URL: https://forms.office.com/Pages/DesignPageV2.aspx?subpage=design&FormId=WNQFcL5FrkiBQNQ9qW3Re0bvB48jbkJKnf3fqVXKunhUQVcyN1NORVkwV05JTUw0N0pHVldYVUs0SC4u

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