G420 Diversity and Inclusion Survey Submission Request 2024

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

TITLE OF INFORMATION COLLECTION: G420: Global Diversity and Inclusion Priorities Survey

PURPOSE: To obtain feedback from other intellectual property offices about their priorities for global diversity and inclusion work. Results will be used as a starting point to facilitate further efforts among IP offices to promote global diversity and inclusion.

DESCRIPTION OF RESPONDENTS: Respondents are individuals who work for other intellectual property offices or the World Intellectual Property Organization.

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.

Business Unit Certification: Karin Ferriter - DCIPC_____________________

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 [ ] 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 Federal Government	No. of Responses	Participation Time	Burden
Survey	72	5 Minutes (0.08 hours)	6 hours
Totals	72	- - -	6 hours

The USPTO estimates that 100% of the surveys will be conducted online.

FEDERAL COST:

The USPTO estimates that it takes 2 hours for summary, data analysis, and reporting for the survey responses per year.

The average hourly rate for a GS-14 step 7 ($80.15) + 30% ($24.05), for a total of $104.20.

The estimated annual cost to the Federal government is the average hourly rate of $104.20 per hour * 2 = $208.

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?

All 72 possible survey respondents are representatives of other intellectual property offices or organizations who are working together with the USPTO to support global diversity and inclusion, and who joined a Joint Statement to recognize International Women’s Day. The survey will be sent via email to the participants’ email address on file.

USPTO estimates around a 50% response rate, which should result in around 36 survey responses for the 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

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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