Request for Approval Submission Form-Export.gov

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0690-0030)

T ITLE OF INFORMATION COLLECTION: Export.gov Customer Feedback Form

PURPOSE:

Our current Website Feedback form, approved under OMB Control No. 0625-0217, only gathers customer satisfaction information on the Export.gov website. Export.gov is now also available to our customers through e-mail updates, Twitter, and FaceBook. In order to better meet our customers’ needs, this enhanced form will gather their satisfaction ratings and comments for these new communication channels in addition to the website. This enhancement will give us the ability to better understand the needs of our customers and to improve our communications to better assist our customers. This form which more correctly set the focus on the customer rather than on the website will replace the Website Feedback form.

The drop-down box on the form will contain:

• About Us and Our Services

• Export Basics

• Safe Harbor

• Free Trade Agreements

• International Finance

• International Logistics

• Regulations and Licensing

• Trade problems and Foreign Trade Barriers

DESCRIPTION OF RESPONDENTS:

Anyone that visits Export.gov can access and complete this form. Export.gov customers generally include U.S. companies, industry associations, and students/researchers.

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: Kimberly Becht

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	No. of Respondents	Participation Time	Burden
Private sector	400	5 mins	33.3
Totals

FEDERAL COST: The estimated annual cost to the Federal government is: $0.

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? [ ] Yes [X] 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?

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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