T ITLE OF INFORMATION COLLECTION: Broker Experience Survey
PURPOSE:
One of the Export-Import (Ex-Im) Bank’s key objectives is to double U.S. exports by 2015, a goal set by President Obama’s National Export Initiative. To achieve that goal, Ex-Im is working to broaden their exporter base, with a special emphasis on growing partnerships with small businesses. At the same time, Ex-Im is undergoing a Total Enterprise Modernization to become more customer-oriented and operationally efficient. Through this effort, Ex-Im will modernize its systems, streamline business processes, and identify new ways to engage with customers. Ex-Im recognizes the importance of gathering input from key stakeholders to ensure that modernization initiatives contribute to the bank’s partnership growth goals. One of the key stakeholder groups Ex-Im has identified are the insurance brokers who serve small businesses. They are instrumental in increasing the bank’s exporter base because they help businesses obtain export credit insurance and make this resource more accessible to small businesses that might not complete the application process themselves. This research effort is designed to help Ex-Im proactively learn about insurance brokers’ needs, experiences and preferences regarding training, the Ex-Im IT platform, interactions with staff, and the overall ease of working with Ex-Im. The objective is to incorporate this feedback into the modernization effort and achieve export goals.
DESCRIPTION OF RESPONDENTS: Respondents are brokers who have current and active policies with the Ex-Im Bank.
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:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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:________________________________________________
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [ X] No
If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
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 |
Broker |
150 |
10 min |
25 hours |
|
|
|
|
Totals |
150 |
10 min |
25 hours |
FEDERAL COST: The estimated annual cost to the Federal government is _$36,175_______
Show
calculation for above using these format
Federal Staff
Review Time (# of hours) 5 (2 minutes per response)
Hourly
rate $30.25 = 151.25 (300 minutes or 5 hours x $30.25)
Overhead rate 28% = 42.35 ($151.25 x .28)
Total Federal Cost =
$193.60 (rounded to $195.00) Government employee cots
Contractor
Cost = $35,980
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
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 sample source is the current list of brokers who have active policies with Ex-Im Bank.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[ X ] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Other, Explain
Will interviewers or facilitators be used? [ ] Yes [ X ] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)
PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.
DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.
TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.
CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.
Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.
Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.
BURDEN HOURS:
Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.
No. of Respondents: Provide an estimate of the Number of Respondents.
Participation Time: Provide an estimate of the amount of time (in minutes) required for a respondent to participate (e.g. fill out a survey or participate in a focus group)
Burden: Provide the Annual burden hours: Multiply the Number of Respondents and the Participation Time then divide by 60.
FEDERAL COST: Provide an estimate of the annual cost to the Federal government.
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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.
Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.
Submit all instruments, instructions, and scripts are submitted with the request.
File Type | application/msword |
File Title | Fast Track PRA Submission Short Form |
Author | OMB |
Last Modified By | whitt |
File Modified | 2013-03-27 |
File Created | 2013-03-27 |