Generic Clearance Request Submission Form

PLEASE READ THESE INSTRUCTIONS CAREFULLY BEFORE SUBMITTING

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g., Customer Satisfaction Survey for Commerce.gov Website)

Request for Website Usability Group Participants for Office for Coastal Management

PURPOSE: Provide a description of the program, system, or product offered to customers, 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.

OCM is redesigning the Digital Coast Data Registry (https://coast.noaa.gov/dataregistry/search/collection) and would like input from our user base on proposed design changes.

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.

The targeted group is users of the Digital Coast Data Registry. These are geospatial data-savvy users.

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.

Our online request would simply be for users to let us know if they would be willing to participate in a usability group. During the usability group (conducted via WebEx), the users would be shown a series of design changes for the site and asked for verbal feedback.

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.

PII that would be collected would be no more than a name and an email address to communicate the date/time of the WebEx focus group).

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

None

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.

Respondents could be form any of the categories listed. We simply want to identify real-world users of our site.

No. of Respondents: Provide an estimate of the Number of respondents.

The usability group would consist of no more than 15 people.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

No more than 2 hours

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60. If an ongoing collection (check yes/no), provide respondents and burden hour totals for duration of your collection up to three years (length of OMB approval).

Example: 3 times a year x 3 yrs (2017) x 25 respondents = 225 responses x 15 mins = 56 hrs.

No more than 30 hours

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

This is routine work for software development staff at OCM. If the purpose is to determine that cost, the estimate would be ~ $500.

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.

OCM will create a banner on the current web page that asks for users to let us know (via email address) if they would like to participate in a web re-design and usability group.

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.

Facilitators for the usability group. Feedback will be verbal; notes will be taken.

Submit all instruments, instructions, and scripts are submitted with the request.

A draft design will be shown and participants will be asked to respond to the design (like/dislike; understand/do not understand). Participants will be asked to offer suggestions for improvements to the design.

Required Additional Information (check ROCIS in IC List for this info ---needed for OCIO staff to complete request)

1. Line of Business: Natural Resources

2. Subfunction: Conservation, marine and land management

3. Privacy Act System of Records: Title: N/A

4. Federal Registration citation information: Volume N/A Pg. No. N/A

5. Number of respondents for small entities: 5

6. Percentage of respondents reporting electronically: 100%

Request for Approval under the

“Generic Clearance for the Collection of Routine Customer Feedback”

OMB Control No. 0690-0030

TITLE OF INFORMATION COLLECTION:

Request for web site usability group participants

PURPOSE:

Usability testing for re-design of web site

DESCRIPTION OF RESPONDENTS:

Web site users

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[x ] 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: _______James Boyd_________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ x ] Yes [ ] No

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

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

N/A

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 Hours
Private sector	5	2 hours	10
State, Local, tribal	5	2 hours	10
Federal	5	2 hours	10
Totals	15	2 hours	30

Ongoing collection? Yes___ or No__x_

FEDERAL COST: The estimated annual cost to the Federal government is __~ $500________

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? [ x ] Yes [ ] No

Please submit all instruments, instructions, correspondences (emails, letters, etc.) to respondents, and scripts as separate documents along with this request document.

No instrument to be used. Participants will be shown web pages and asked to provide verbal feedback.

Every instrument (survey/form) or correspondence to respondents must have the following displayed –

OMB Control No. 0690-0030

Expiration Date: 06/30/2017

The standard PRA Notwithstanding statement informing respondents of the OMB control number’s legal significance in accordance with 5 CFR 1320.5(b).

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