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

Forms and Documents

Document Name	Status
Fast Track Generic Clearance Supporting Statement Part A - Army DCoE - FINAL.docx Supporting Statement A	2015-12-18
DMDC Recommendation Letter for DCoE Generic Clearance for the Collection of Qualitative Feedback 20151202.PDF Supplementary Document	2015-12-17
5)LegislativeMandates.PDF Supplementary Document	2015-12-17
Fast Track Generic Clearance Supporting Statement Part B - Army DCoE.doc Supporting Statement B	2015-12-17

IC Document Collections

IC ID	Document Title	Status
219330	Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Other-Question Bank	New

ICR Details

OMB Control No: 0704-0552	ICR Reference No: 201512-0704-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/18/2016
	Date Received in OIRA: 12/18/2015
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	02/28/2019	36 Months From Approved
Responses	10,000	0	0
Time Burden (Hours)	1,667	0	0
Cost Burden (Dollars)	37,240	0	0

---

Abstract: The mission of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) is to improve the lives of our nation's service members, veterans and their families by advancing excellence in psychological health and traumatic brain injury prevention and care. DCoE is requesting a fast track generic clearance to obtain feedback from these audiences as well as military treatment providers regarding DCoE's clinical and educational products and services. The information will be utilized to inform product improvement, utilization, impact and to identify gaps in product offerings to better meet stakeholders' needs.

---

Authorizing Statute(s): PL: Pub.L. 110 - 181 NDAA for FY 2008 Name of Law: null
   EO: EO 12862 Name/Subject of EO: null
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 71404	12/02/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 79032	12/18/2015
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

---

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	10,000	0	0	10,000	0	0
Annual Time Burden (Hours)	1,667	0	0	1,667	0	0
Annual Cost Burden (Dollars)	37,240	0	0	37,240	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is new fast track generic.

---

Annual Cost to Federal Government: $41,350

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

---

Common Form ICR:  No

---

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: 12/18/2015

---