2016 EIA Web Product Survey Generic Template Summary

Request for Approval under the “Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery” (OMB Control Number: 1905-0210)

TITLE OF INFORMATION COLLECTION:

2016 EIA Web Product Survey - Gasoline and Diesel Fuel Update Report

PURPOSE: The purpose of this short survey is to collect feedback from retail motor gasoline users of the Gasoline and Diesel Fuel Update Report on the EIA website to help us make decisions about modifying the existing web product. We are specifically interested in getting feedback on the user’s familiarity with our product, specific data and information needs, and how they use our product.

DESCRIPTION OF RESPONDENTS:

Respondents will be users of Gasoline and Diesel Fuel Update Report on the EIA website, see the respective URL address below. The survey will only target the users who browse this product during the time the survey is live and subscribers to our weekly retail motor gasoline email list.

Web Product and URL Address

Gasoline and Diesel Fuel Update - https://www.eia.gov/petroleum/gasdiesel/

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] 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: Nanda Srinivasan, Director, Office of Survey Development and Statistical Integration

U.S. Energy Information Administration

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? [ ] Yes [X] No

BURDEN HOURS

The attached survey will take about three minutes to complete based on tests conducted with sample participants. The burden for the targeted customer group should not exceed 50 hours (1,000 potential respondents multiplied by 3 minutes each).

Category of Respondent	No. of Respondents	Participation Time (minutes)	Burden Hours
Totals (number of respondents for each survey times minutes, frequency for survey is once per year)	3,881 (up to 1 month)	3	194

FEDERAL COST: There are no additional costs to the federal government anticipated. Expenses (equipment, overhead, printing, and support staff) will be incurred by EIA components as part of their normal operating budgets.

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? [X ] 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 will be users of the Gasoline and Diesel Fuel Update Report and subscribers to EIA’s weekly retail gasoline email list. This survey will only target users who browse this web product on our website when the survey is live. The weekly email list has over 10,000 subscribers. EIA will insert text in the email that invite users to participate in the volunteer survey. One web product survey would be conducted on the EIA website at a time. The survey will only be conducted once annually.

EIA plans to have the survey on its website for a specified time period, or until a specified number of responses are received, whichever occurs first. The specified time period and the number of responses for the survey is identified above under Burden Hours. The number of returns will be monitored daily.

Administration of the Instrument

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

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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

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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