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

Forms and Documents

Document Name	Status
Generic Clearance Submission Template (2).doc Supplementary Document	2011-06-01
Qualitative Feedback Justification B.docx Supporting Statement B	2011-02-24
Administrations-Qualitative_Feedback_Justification.doc Supporting Statement A	2014-06-26

IC Document Collections

IC ID	Document Title	Status
228035	Primary Care Satisfaction Survey Other-Survey	New
228034	VHA Pallative Care Telehealth Appointments / Mental Health Veterans Survey Other-Usability scale	New
228031	VBA Veterans Success on Campus (VSOC) Survey Other-Survey	New
228030	VA and DoD Digital services Brand Survey Other-Email Survey	New
205043	Federal Contractor Certification Program Survey (revised) Other-Survey	Unchanged
204936	Focus Groups for attitudes, opinions, perceptions and awareness about VA Other-Script	Unchanged
204821	Federal Contractor Certification Program Survey Other-Survey	Unchanged
203854	Department of Veterans Affairs Financial Services Center Customer Support Help Desk Survey Other-Survey	Unchanged
202472	Project Reach Survey Other-Survey	Unchanged
198094	Roundtable on Veterans' Business Issues Instruction	Unchanged

ICR Details

OMB Control No: 2900-0769	ICR Reference No: 201404-2900-002
Status: Historical Active	Previous ICR Reference No: 201102-2900-009
Agency/Subagency: VA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Administrations)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/21/2014
	Date Received in OIRA: 06/26/2014
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	36 Months From Approved	08/31/2014
Responses	100,000	0	100,000
Time Burden (Hours)	50,000	0	50,000
Cost Burden (Dollars)	0	0	0

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Abstract: The generic clearance will be used to collect qualitative feedback on VA's services or products delivery. VA will seek customer and stakeholder perceptions, experiences and expectations on its services or products delivery. The data collected will be used to improve delivery of products or services in areas where needed.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 68	04/09/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 123	06/26/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
Roundtable on Veterans' Business Issues
Department of Veterans Affairs Financial Services Center Customer Support Help Desk Survey
Federal Contractor Certification Program Survey (revised)
Primary Care Satisfaction Survey
Project Reach Survey
VHA Pallative Care Telehealth Appointments / Mental Health Veterans Survey
Federal Contractor Certification Program Survey
Focus Groups for attitudes, opinions, perceptions and awareness about VA
VBA Veterans Success on Campus (VSOC) Survey
VA and DoD Digital services Brand Survey

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	100,000	100,000	0	0	0	0
Annual Time Burden (Hours)	50,000	50,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New data collection.

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Annual Cost to Federal Government: $150,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/26/2014

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