Ames fast track

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

1. Title of information collection	NASA ARC Center Master Plan Survey
2. Purpose	NASA Ames Research Center (ARC) is preparing for the development of its new facilities master plan. This feedback survey is to gather insights and inputs across the center workforce towards helping inform the vision of the future.
3. Description of respondents	NASA ARC Center Civil Servants and Contractors

4. Type of collection (check one)

Customer comment card/complaint form	Customer satisfaction survey
Usability testing (e.g., website, software)	Small discussion group
Focus group	Other: Feedback Survey

5. Personally identifiable information

Will PII be collected?	Yes	No
If yes: will any information that is collected be included in records that are subject to the Privacy Act of 1974?	Yes	No
If yes: has an up-to-date System of Records Notice (SORN) been published?	Yes	No

6. Gifts or payments

Is an incentive provided to participants? (e.g., money, reimbursement of expenses, token of appreciation)

Yes

No

7. Burden time per response

Category of respondent	Number of respondents, per year	Participation time (list in minutes)	Total burden time (in hours)
Civil servant (voluntary-not everyone may respond.)	1300	5	108 hours
Contractor (voluntary-not everyone may respond.)	2200	5	183 hours
Totals	3500	5	291 hours

8. Federal cost (If any, typically listed as the total burden time in hours x $30 = federal cost. This includes: printing, shipping, IT, contracting, and does not include salaries)

      0

9. The selection of your targeted respondents

Do you have a customer list or similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe?	Yes	No
If yes, please provide a description of both below (attach a sampling plan if available). Potential respondents will be the Ames civil servants and contractors (3,500 employees). We will email the entire Civil servant and contractor teams in hopes of receiving 20% to 25% response rate. The ARC Office of Communications maintains the center distribution list that will be leveraged for survey dissemination.
If no, please provide a description of how you plan to identify your potential group of respondents and how you will select them.      

10. Administration of the instrument (check all that apply)

Web-based or email (SurveyMonkey, MS Forms, etc)	Telephone	In person	Snail mail
Other, please list:      
Will interviewers or facilitators be used?		Yes	No
Please provide the URL: https://www.surveymonkey.com/r/Preview/?sm=LuloXejAHxG_2BhjlcOVMG7qzxRfI4e3HnOal_2BcYt2O9h_2F0RT2PHd7KmvUs8qm35Bo

11. Certification. Please certify the following to be true

The collection is voluntary.

The collection is low-burden for respondents and low-cost for the Federal Government.

The collection is non-controversial and does not raise issues of concern to other federal agencies The results are not intended to be disseminated to the public.

Information gathered will not be used for the purpose of substantially informing influential policy decisions.

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: Soheila Dianati

Center, division, & program: Ames Research Center, Center Operations Directorate, Center Master Plan

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