Traffic Incident Management (TIM)/Planned Special Event (PSE) Conference – Customer Feedback

TIM_PSE Fast Track Form.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Traffic Incident Management (TIM)/Planned Special Event (PSE) Conference – Customer Feedback

OMB: 2125-0628

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number 2125-0628)

Shape1 TITLE OF INFORMATION COLLECTION: Traffic Incident Management (TIM)/Planned Special Event (PSE) Conference – Customer Feedback


PURPOSE:

The Federal Highway Administration is trying to determine if there is interest in another TIM/PSE conference as well as what the conference should look like. FHWA has co-sponsored, supported or sponsored TIM/PSE conferences in the past and wishes to see if interest in another conference exists before beginning to plan a 2014 or 2015 conference.



DESCRIPTION OF RESPONDENTS:

Transportation, Public Safety, Fire, Emergency Medical professionals who either respond as emergency responders to traffic incidents and/or who plan and implement both transportation plans and traffic incident management plans for planned special events. Both traffic incidents and planned special events are major causes of non-recurring congestion. Traffic incidents account for a number of deaths and struck-bys to those responding to the incidents – whether they responders are police, fire or DOT employees.


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: Laurel J. Radow_________________________________________


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, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

  3. If Yes, has an up-to-date System of Records Notice (SORN) 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

State and Local Government

100

30 minutes

50 hours





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

  1. 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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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2021-01-31

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