Request for Approval

Request for Approval under the “DOI Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery”

(OMB Control Number: 1090-0011)

TITLE OF INFORMATION COLLECTION:

Neal Smith National Wildlife Refuge - Public Program Feedback Form

PURPOSE:

We will use this survey as a post-assessment tool following our public interpretive programs. We will use the feedback to gauge audience satisfaction with content, and to improve/make changes per audience suggestions.

DESCRIPTION OF RESPONDENTS:

Respondents will be members of the public who voluntarily attend Neal Smith National Wildlife Refuge interpretive programs. In 2017, 2,813 visitors attended 64 public programs at the refuge. We are assuming annual visitation will be similar in the future. Since this is a voluntary survey, we estimate that about 15% of potential respondents will participate (per survey research). This gives us about 422 total respondents (2,813 x 0.15 = 422).

TYPE OF COLLECTION: (Check one)

Customer Comment Card/Complaint Form Customer Satisfaction Survey

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: Patrick Bryant, Park Ranger, Neal Smith National Wildlife Refuge, USFWS

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

Personally Identifiable Information:

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

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

3. If Applicable, has a System or Records Notice been published? Yes No If “Yes”, please include the SORN title, number, and Federal Register citation for the publication:

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? Yes No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Total Hour Burden
Individuals/Households	422	5 mins	35.16 hours

FEDERAL COST: The estimated annual cost to the Federal government is $743 (rounded). We estimate that of the 2,816 public program participants, only about 15% will respond to a voluntary feedback form (per survey research). Volunteers and interns not paid by the federal government will hand out, collect and review surveys. Volunteers and interns will determine which surveys have addressable feedback, categorizing responses and passing them along to staff. We estimate 2 minutes of staff time per response required to apply feedback (2 minutes x 422 respondents/ 60 minutes = 14.06 hours). We then multiplied the 14.02 hour estimate by the fully burdened hourly pay of $52.85 (OPM table 2018-RUS) for a GS-11/05 employee ($33.24 X 1.59 per BLS News Release USDL-18-0451) = $743.07.

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 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.

Respondents must be participants of Neal Smith National Wildlife Refuge interpretive programs. In 2017, 2,813 visitors attended 64 public programs at the refuge. We are assuming annual visitation will be similar in the future. Since this is a voluntary survey, we estimate that about 15% of potential respondents will participate (per survey research). This gives us about 422 total respondents (2,813 x 0.15 = 422). Surveys will only be given at the end of a public program—respondents must have attended the entirety of the program to be eligible.

Administration of the Instrument

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

Web-based or other forms of Social Media

Telephone

In-person

Mail

Other, Explain

2. Will interviewers or facilitators be used? Yes No

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