Generic Request for the Collection of Routine Customer Feedback” (OMB Control Number: 1670-0027) NPPD Analysis Customer Feedback

Generic Clearance Submission Template -- NPPD Analysis Customer Feedback Survey.docx

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

Generic Request for the Collection of Routine Customer Feedback” (OMB Control Number: 1670-0027) NPPD Analysis Customer Feedback

OMB: 1670-0027

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1670-0027)

Shape1 TITLE OF INFORMATION COLLECTION: NPPD Analysis Customer Feedback Survey


PURPOSE: NPPD produces analysis to inform cyber and physical infrastructure security and resiliency decisions, policies, and strategies. To ensure these analytic products are actionable, effective, relevant, and timely NPPD would like to obtain feedback from its customers by affixing a brief, optional survey to each of its assessments that customers may electronically submit to an NPPD owned account. NPPD will then analyze the data from the surveys to improve its analysis and to inform other production and dissemination process improvements.


DESCRIPTION OF RESPONDENTS: Survey participants will include Federal, State, local, tribal, territorial, and private sector critical infrastructure community partners who consume NPPD analytic products. Participants may range from NPPD Leadership to critical infrastructure owners and operators.


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: /s/ Dean Checknita












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, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

  3. If Applicable, has a System or Records Notice been published? [ ] Yes [X] 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


Category of Respondent

No. of Respondents

Participation Time

Burden

Private Sector

1100

0.11 hours

121 hours/

year





Totals



121 hours/

year



FEDERAL COST: The estimated annual cost to the Federal government is $1218.75


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?


Recipients are determined by standard distribution lists dependent upon product type.


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

[X] Other (email response)


  1. 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 Routine Customer Feedback”


Shape2

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.


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.

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.


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


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2021-01-23

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