Program Evaluation Instruments - Environmental Conflict Resolution Services Participant Questionnaires (Five Instruments)

Forms and Documents

Document	Type	Status	Availability
Form 3320-0003 (A) Assessment Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (E) Facilitated Process Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (E) Facilitated Process Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (E) Facilitated Process Evaluation	Form and Instruction	Unchanged	Repair queued
Form 3320-0003 (E) Facilitated Process Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (D) ECCR Support Services Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (D) ECCR Support Services Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (D) ECCR Support Services Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (D) ECCR Support Services Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (C) Facilitated Meeting Workshop Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (C) Facilitated Meeting Workshop Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (C) Facilitated Meeting Workshop Questionnaire	Form and Instruction	Unchanged	Repair queued
Form 3320-0003 (C) Facilitated Meeting Workshop Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (B) Mediation Services Participant Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (B) Mediation Services Participant Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (B) Mediation Services Participant Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (B) Mediation Services Participant Questionnaire	Form and Instruction	Unchanged	Available
Form 3320-0003 (A) Assessment Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (A) Assessment Evaluation	Form and Instruction	Unchanged	Available
Form 3320-0003 (A) Assessment Evaluation	Form and Instruction	Unchanged	Available
Justification for No Material, Non-substantive Change - Udall Foundation.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-05-15	Available
SUPPORTING STATEMENT - Combined ECCR ICs - Non-substantive Update - redine.docx	Supplementary Document	Uploaded 2025-05-15	Available
SUPPORTING STATEMENT - Combined ECCR ICs.pdf	Supporting Statement B	Uploaded 2024-03-28	Available
SUPPORTING STATEMENT - Combined ECCR ICs - Non-substantive Update - Clean.docx	Supporting Statement A	Uploaded 2025-05-15	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
35883	Assessment Evaluation - Federal Respondents	Form and Instruction	Unchanged	Assessment Evaluation
265987	Facilitated Process Evaluation - State Local Tribal Respondents	Form and Instruction	Unchanged	Facilitated Process Evaluation
265986	Facilitated Process Evaluation - Private Sector Respondents	Form and Instruction	Unchanged	Facilitated Process Evaluation
265985	Facilitated Process Evaluation - Individual or Household Respondents	Form and Instruction	Unchanged	Facilitated Process Evaluation
265984	Facilitated Process Evaluation - Federal Respondents	Form and Instruction	Unchanged	Facilitated Process Evaluation
265983	ECR Support Services Evaluation - State Local Tribal Respondents	Form and Instruction	Unchanged	ECCR Support Services Questionnaire
265982	ECR Support Services Evaluation - Private Sector Respondents	Form and Instruction	Unchanged	ECCR Support Services Questionnaire
265981	ECR Support Services Evaluation - Individual or Household Respondents	Form and Instruction	Unchanged	ECCR Support Services Questionnaire
265980	ECR Support Services Evaluation - Federal Respondents	Form and Instruction	Unchanged	ECCR Support Services Questionnaire
265979	Facilitated Meeting/ Workshop Services - State Local and Tribal Respondents	Form and Instruction	Unchanged	Facilitated Meeting Workshop Questionnaire
265978	Facilitated Meeting/ Workshop Services - Private Sector Respondents	Form and Instruction	Unchanged	Facilitated Meeting Workshop Questionnaire
265977	Facilitated Meeting/ Workshop Services - Individual or Household Respondents	Form and Instruction	Unchanged	Facilitated Meeting Workshop Questionnaire
265976	Facilitated Meeting/ Workshop Services - Federal Respondents	Form and Instruction	Unchanged	Facilitated Meeting Workshop Questionnaire
265975	Mediation Services Participant Questionnaire - State Local and Tribal Respondents	Form and Instruction	Unchanged	Mediation Services Participant Questionnaire
265974	Mediation Services Participant Questionnaire - Private Sector Respondents	Form and Instruction	Unchanged	Mediation Services Participant Questionnaire
265973	Mediation Services Participant Questionnaire - Individual or Household Respondents	Form and Instruction	Unchanged	Mediation Services Participant Questionnaire
265972	Mediation Services Participant Questionnaire - Federal Respondent	Form and Instruction	Unchanged	Mediation Services Participant Questionnaire
185868	Assessment Evaluation - Individual or Household Respondents	Form and Instruction	Unchanged	Assessment Evaluation
185867	Assessment Evaluation - Private Sector Respondents	Form and Instruction	Unchanged	Assessment Evaluation
185866	Assessment Evaluation - State Local Tribal Respondents	Form and Instruction	Unchanged	Assessment Evaluation

ICR Details

OMB Control No: 3320-0003	ICR Reference No: 202505-3320-002
Status: Received in OIRA	Previous ICR Reference No: 202403-3320-002
Agency/Subagency: MKU-SLUF	Agency Tracking No: 0003
Title: Program Evaluation Instruments - Environmental Conflict Resolution Services Participant Questionnaires (Five Instruments)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/15/2025

	Requested	Previously Approved
Expiration Date	04/30/2027	04/30/2027
Responses	765	765
Time Burden (Hours)	100	100
Cost Burden (Dollars)	6,437	6,437

---

Abstract: As part of its program evaluation system, the John S. McCain III National Center for Environmental Conflict Resolution (National Center) plans to collect information on the quality of its services. The information collections (ICs) used for this program are being consolidated under a single Information Collection Request (ICR). All will be separate ICs under ICR 3320-0003. These ICs are: • National Center for Environmental Conflict Resolution Assessment Evaluation – Requester Questionnaire (former 3320-0003); • Mediation Services Participant Questionnaire (Agreement Seeking) (former 3320-0004); • Facilitated Meeting/Workshop Services (former 3320-0007); • ECR Support Services Evaluation – Requester Questionnaire (former 3320-0009); and • National Center for Environmental Conflict Resolution Facilitated Process Evaluation – Participant Questionnaire (former 3320-0010).

---

Authorizing Statute(s): PL: Pub.L. 105 - 156 5 Name of Law: Environmental Policy and Conflict Resolution Act of 1998
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 63630	09/15/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 21541	03/28/2024
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 20

IC Title	Form No.	Form Name
Assessment Evaluation - Federal Respondents	3320-0003 (A)	Assessment Evaluation
Assessment Evaluation - Individual or Household Respondents	3320-0003 (A)	Assessment Evaluation
Assessment Evaluation - Private Sector Respondents	3320-0003 (A)	Assessment Evaluation
Assessment Evaluation - State Local Tribal Respondents	3320-0003 (A)	Assessment Evaluation
ECR Support Services Evaluation - Federal Respondents	3320-0003 (D)	ECCR Support Services Questionnaire
ECR Support Services Evaluation - Individual or Household Respondents	3320-0003 (D)	ECCR Support Services Questionnaire
ECR Support Services Evaluation - Private Sector Respondents	3320-0003 (D)	ECCR Support Services Questionnaire
ECR Support Services Evaluation - State Local Tribal Respondents	3320-0003 (D)	ECCR Support Services Questionnaire
Facilitated Meeting/ Workshop Services - Federal Respondents	3320-0003 (C)	Facilitated Meeting Workshop Questionnaire
Facilitated Meeting/ Workshop Services - Individual or Household Respondents	3320-0003 (C)	Facilitated Meeting Workshop Questionnaire
Facilitated Meeting/ Workshop Services - Private Sector Respondents	3320-0003 (C)	Facilitated Meeting Workshop Questionnaire
Facilitated Meeting/ Workshop Services - State Local and Tribal Respondents	3320-0003 (C)	Facilitated Meeting Workshop Questionnaire
Facilitated Process Evaluation - Federal Respondents	3320-0003 (E)	Facilitated Process Evaluation
Facilitated Process Evaluation - Individual or Household Respondents	3320-0003 (E)	Facilitated Process Evaluation
Facilitated Process Evaluation - Private Sector Respondents	3320-0003 (E)	Facilitated Process Evaluation
Facilitated Process Evaluation - State Local Tribal Respondents	3320-0003 (E)	Facilitated Process Evaluation
Mediation Services Participant Questionnaire - Federal Respondent	3320-0003 (B)	Mediation Services Participant Questionnaire
Mediation Services Participant Questionnaire - Individual or Household Respondents	3320-0003 (B)	Mediation Services Participant Questionnaire
Mediation Services Participant Questionnaire - Private Sector Respondents	3320-0003 (B)	Mediation Services Participant Questionnaire
Mediation Services Participant Questionnaire - State Local and Tribal Respondents	3320-0003 (B)	Mediation Services Participant Questionnaire

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	765	765	0	0	0	0
Annual Time Burden (Hours)	100	100	0	0	0	0
Annual Cost Burden (Dollars)	6,437	6,437	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Most of the changes are the result of consolidating five separate ICR numbers into a single ICR with multiple ICs. The remaining differences are based on changes in agency estimates. One previous IC has been removed because it is no longer part of the program.

---

Annual Cost to Federal Government: $30,290

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/15/2025

---