Submission Request Form

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

T ITLE OF INFORMATION COLLECTION:

Customer Results Survey on EDA/ITA Trade and Investment Programs (“Programs”).

PURPOSE: To identify the effectiveness of these Programs and determine if they have resulted in or are expected to result in Foreign Direct Investment (FDI) in the regions of the United States that participated in the Programs. FDI is a long-term process, so while satisfaction surveys are completed on-site regarding logistics and other short-term satisfaction, but longer term follow-up is needed to discover if the Programs were successful for the participants. These results will be used to judge whether or not these programs are effective in gaining FDI and creating jobs.

DESCRIPTION OF RESPONDENTS: Participants in Programs that represented states, counties, cities, and other entities responsible for economic development in their regions.

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: Laura Stierle

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, local, or tribal governments	35	15 minutes	9 hours
Private sector	35	15 minutes	9 hours
Totals	70	15 minutes	18 hours

FEDERAL COST: The estimated annual cost to the Federal government is $128.

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?

Customer List: All participants in past Programs (approximately 70 people)

Survey Universe: All participants in past Programs (approximately 70 people)

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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