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

Forms and Documents

Document Name	Status
Base Ensemble Extended Wear Testing Form	New
Firefighter Accountability Proximity Project NEON Proximity Unit Form	New
Acquisition 360 Survey Form and Instruction	New
Seacoast WAMS User Feedback Form Form	New
Form DHS Form 10093 STC Los Angeles/Long Beach Regional Stakeholder Survey Form	New
CIS Ombudsman 2015 Annual Conference Evaluation Form Form	New
Form DHS Form 0041 JAC AND JACCIS CUSTOMER SATISFACTION SURVEY Form	New
Form MCP-FM-NMC4-78 National Maritime Center Customer Satisfaction Survey Form	New
1601-0014_30 day FRN published.pdf Supplementary Document	2015-03-19
1601-0014_60 day FRN published.pdf Supplementary Document	2015-03-19
1601-0014_Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery A.docx Supporting Statement A	2015-03-19
Generic_Clearance_Submission_Template.doc Supplementary Document	2014-10-31
Executive Order 12862.pdf Supplementary Document	2014-10-31
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Part B.doc Supporting Statement B	2014-10-31

IC Document Collections

IC ID	Document Title	Status
229977	Base Ensemble Extended Wear Testing Form	New
228711	Area Contingency Planning Survey Other-null	New
227387	Special Victim's Counsel Feedback Other-Survey Monkey Instrument	New
225319	Firefighter Accountability Proximity Project NEON Proximity Unit Form	New
222571	Acquisition 360 Survey Form and Instruction	New
220073	Seacoast WAMS User Feedback Form Form	New
219616	STC Los Angeles/Long Beach Regional Stakeholder Survey Form	New
218500	CIS Ombudsman 2015 Annual Conference Evaluation Form Form	New
218090	Customer Satisfaction for DHS Websites Other-Mock-Up for Online Survey	New
217903	JAC AND JACCIS CUSTOMER SATISFACTION SURVEY Form	New
216997	National Maritime Center Customer Satisfaction Survey Form	New
216332	DHS Pre-award and Debriefing Satisfaction Survey Other-Survey	New

ICR Details

OMB Control No: 1601-0014	ICR Reference No: 201410-1601-003
Status: Historical Active	Previous ICR Reference No: 201201-1601-001
Agency/Subagency: DHS/OS	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/27/2015
	Date Received in OIRA: 10/31/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved	04/30/2015
Responses	200,000	0	45,098
Time Burden (Hours)	375,148	0	375,148
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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

Citations for New Statutory Requirements: None

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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 53435	09/09/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 74734	12/16/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 12

IC Title	Form No.	Form Name
Acquisition 360 Survey	n/a	Acquisition 360 Survey
CIS Ombudsman 2015 Annual Conference Evaluation Form	n/a	2015 CIS Ombudsman Annual Conference Feedback Form
Firefighter Accountability Proximity Project NEON Proximity Unit	n/a	n/a
Base Ensemble Extended Wear Testing	n/a	Base Ensemble Extended Wear Testing
DHS Pre-award and Debriefing Satisfaction Survey
Area Contingency Planning Survey
National Maritime Center Customer Satisfaction Survey	MCP-FM-NMC4-78	National Maritime Center Website Feedback
Special Victim's Counsel Feedback
Seacoast WAMS User Feedback Form	n/a	Seacoast WAMS User Feedback Questions
Customer Satisfaction for DHS Websites
STC Los Angeles/Long Beach Regional Stakeholder Survey	DHS Form 10093	STC Member Questionnaire
JAC AND JACCIS CUSTOMER SATISFACTION SURVEY	DHS Form 0041	JAC 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	200,000	45,098	0	0	154,902	0
Annual Time Burden (Hours)	375,148	375,148	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:

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Annual Cost to Federal Government: $600,000

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: 10/31/2014

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