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pdfRequest for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number:1530-0023)
TITLE OF INFORMATION COLLECTION: myRA Creative Testing
PURPOSE: The purpose of this project is to obtain feedback on messages and materials being
developed to support myRA.
DESCRIPTION OF RESPONDENTS: This research will be conducted with two types of
respondents: 1) individuals from the general public who are the financial decision makers in
their household and 2) employer decision makers for small, medium and large companies (both
those that do and do not currently offer payroll-based retirement accounts to their employees).
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[X] Focus Group
[ ] Customer Satisfaction Survey
[ ] Small Discussion 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.
Digitally signed by Bruce A. Sharp
DN: c=US, o=U.S. Government, ou=Department of the Treasury, ou=Bureau of
the Public Debt, ou=People, serialNumber=404211, cn=Bruce A. Sharp
Date: 2015.02.13 14:37:48 -05'00'
Name:________________________________________________
Bruce A. Sharp
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? [X] Yes [ ] No
General public focus group and bulletin board participants will receive approximately $75
based on prevailing rates for the location.
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Business benefits decision-maker focus group participants (from small, medium, and large-sized
companies) receive approximately $150 based on prevailing rates for the location.
Business benefits decision-makers from small, medium, and large companies will receive
approximately $125 for participating in the bulletin boards per prevailing rates.
BURDEN HOURS
Category of Respondent
Bulletin-Board Groups – Private Sector Business
Decision Makers
Bulletin-Board Groups – General Public
Focus Group Participants – Private Sector Business
Decision Makers
Focus Group Participants – General Public
Individuals
Totals
No. of
Participation
Respondents Time
14
1.5 hrs
Burden
14
18
1.5 hrs
2.5 hrs
21 hrs
45 hrs
21
2.5 hrs
52.5 hrs
67
2.1 hrs average
139.5
hrs
21 hrs
FEDERAL COST: The estimated annual cost to the Federal government is not known at this
time.
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?
The screening protocol for consumers is designed to recruit participants who are employed and
who represent a cross-section of the population in terms of gender, race/ethnicity, age, income,
education, employment status, asset levels, and current retirement savings behaviors.
The screening protocol for employer decision makers will ensure that focus group participants
are from small, medium, and large-sized companies and that some represent companies who
currently do offer payroll-based retirement accounts to employees and others that do not
currently offer this benefit. See attached Screeners.
Administration of the Instrument
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1. How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media
[X] Telephone
[X] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [X] Yes [ ] No
Please make sure that all instruments, instructions, and scripts are submitted with the
request.
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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. 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 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 responses and the
participation time and 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.
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File Type | application/pdf |
File Title | DOCUMENTATION FOR THE GENERIC CLEARANCE |
Author | 558022 |
File Modified | 2015-02-13 |
File Created | 2015-02-13 |