IC Template - Parents and Workplace

Request for Approval under the “GENERIC CLEARANCE FOR QUALITATIVE
CONSUMER EDUCATION, ENGAGEMENT, AND EXPERIENCE INFORMATION
COLLECTIONS”

(OMB Control Number: 3170-0036)
1. TITLE OF INFORMATION COLLECTION:
Parents Initiative: Parents in the Workplace
2. PURPOSE:
To determine what kind of financial wellness programs exist to help parents in the workplace
with their children’s financial futures, and to determine interest in this type of program among
employers and their employees.
3. DESCRIPTION OF RESPONDENTS:
Human Resources and Benefits personnel at large and small organizations
4. TYPE OF COLLECTION (ADMINISTRATION OF THE INSTRUMENT):
a.

How will you collect the information? (Check all that apply)
[
[
[
[

] Web-based or other forms of Social Media
] In-person
] Small Discussion Group
] Other, Explain ______________________

[X] Telephone
[ ] Mail
[ ] Focus Group

b. Will interviewers or facilitators be used?
[X] Yes [ ] No [ ] Not Applicable
5. FOCUS GROUP OR SURVEY:
If you plan to conduct a focus group or survey, please provide answers to the following
questions:
a. 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 [ ] Not Applicable
b. If the answer is yes, please provide a description below. 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?
We have assembled a list of about 100 likely organizations. We will send an invitation e-mail to

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the organizations asking for their participation in this effort. We will schedule telephone
interviews with the organizations on a first-come, first-served basis until we have successfully
interviewed 9 organizations with less than 500 employees, and 9 organizations with 500 or more
employees.
6. INFORMATION COLLECTION PROCEDURES
Please summarize the procedures that will be used to collect data from respondents.
The interviewer will take notes of the call, and the call will be recorded as an mp3 and
saved as a file at the vendor.
7. PERSONALLY IDENTIFIABLE INFORMATION:
a. Is personally identifiable information (PII) collected? [X] Yes [ ] No
b. If Yes, is the information that will be collected included in records that are subject
to the Privacy Act of 1974? [X ] Yes [ ] No [ ] Not Applicable
c. If Applicable, has a System of Records Notice been published?
[X ] Yes [ ] No [ ] Not Applicable
CFPB.021 - CFPB Consumer Education and Engagement Records, 79 FR 78839
8. INCENTIVES:
a. Is an incentive provided to participants? [ ] Yes [ X] No
b. If Yes, provide the amount or value of the incentive? N/A
If Yes, provide a statement justifying the use and amount of the incentive.
N/A
9. ASSURANCES OF CONFIDENTIALITY:
a. Will a pledge of confidentiality be made to respondents? [ ] Yes [X] No
b. If Yes, please cite the statue, regulation, or contractual terms supporting the pledge. N/A

10. JUSTIFICATION OF SENSITIVE QUESTIONS (if applicable): N/A
11. BURDEN HOURS:
Category of
Respondent
Interviews

Number of
Respondents

Frequency

Number of
Responses

1x

18

18

Response
Time
(hours)
1.5

12. FEDERAL COST: The estimated annual cost to the Federal government is $__0__.

2

Burden
(hours)
27

13. CERTIFICATION:
CERTIFICATION PURSUANT TO 5 CFR 1320.9, AND THE RELATED PROVISIONS
OF 5 CFR 1320.8(b)(3) :
By submitting this document, the Bureau certifies the following to be true:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It uses plain, coherent, and unambiguous terminology that is understandable to respondents;
(d) Its implementation will be consistent and compatible with current reporting and
recordkeeping practices;
(e) It indicates the retention period for recordkeeping requirements;
(f) It informs respondents of the information called for under 5 CFR 1320.8(b)(3):
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(g) 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;
(h) It uses effective and efficient statistical survey methodology; and
(i) It makes appropriate use of information technology.

CERTIFICATION FOR INFORMATION COLLECTIONS SUBMITTED UNDER A
GENERIC INFORMATION COLLECTION PLAN
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By submitting this document, the Bureau certifies the following to be true:
The collection is voluntary.
The collection is low-burden for respondents.
The collection is non-controversial and does not raise issues of concern to other federal
agencies. Information gathered will not be used for the purpose of substantially informing
influential policy decisions.
The collection is not statistically significant; the results are not intended to be
generalizable beyond the survey population.
The results will not be used to measure regulatory compliance or for program evaluation.

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