G412 Join the List Survey Submission Request

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0651-0080)

TITLE OF INFORMATION COLLECTION: G412: “Join the List” Survey 2024

PURPOSE: The purpose of this data collection is to acquire feedback from event attendees when USPTO recruiters visit career fairs. The results of this survey will be secured on SharePoint and shared only to those that directly act upon this data. The OHR Marketing team will send future curated emails based on their responses containing information regarding internships, externships, or becoming a patent examiner with the USPTO.

DESCRIPTION OF RESPONDENTS:

Event attendees – undergraduate and graduate students, alumni, and university staff.

TYPE OF COLLECTION: (Check one or multiple)

[ ] 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.

Business Unit: _________Amber Pietro - OCAO OHR _______________________

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

Personally Identifiable Information:

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

1a. If Yes, is the information that will be collected included in records that are subject to

the Privacy Act of 1974? [ X ] Yes [ ] No

2. If applicable, has a System of Records Notice been published? [ X ] Yes [ ] No

COMMERCE/PAT-TM-19 Dissemination Events and Registrations

Gifts or Payments:

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

BURDEN HOURS

Name of Instrument	No. of Respondents	Participation Time	Burden
“Join the List” Survey – Individuals & Households	400	3 min	20 hrs
Totals	400	- - -	20 hours

The USPTO estimates that 100% of the surveys (small discussions, focus groups, etc.) will be conducted electronically.

FEDERAL COST: The estimated annual cost to the Federal government is the combined average hourly rate of $31.12 per hour for a GS-9 step 1 + 9.34 (30%) * 1 hour, which totals an hourly rate of $40.46. $40.46 * 1 hour = $40.46

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?

The “Join the List” survey will be created using Microsoft Forms. Once published, the url to access the form will be created into a QR code. During a recruitment event, there will be a table-top stand at the USPTO booth which will display this QR code. Recruiters will ask interested event attendees to scan the QR code and complete the voluntary survey.

Administration of the Instrument

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

[X ] Web-based or other forms of Social Media – will be hosted on Microsoft Forms.

Form url will be created into a QR code and display on table-top sign at the recruitment event booth. This QR code may also be used in virtual and in-person recruitment information session presentations.

[ ] Telephone

[] In-person

[ ] Mail

[ ] Other, Explain: live poll software

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

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