Fast track TTIPO fellowship project

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control #: 0925-0648 Exp. Date: 05/2021)

TITLE OF INFORMATION COLLECTION: NIAID Technology Transfer and Intellectual Property Office (TTIPO) Fellowship Program Survey

PURPOSE: The survey will be to collect anonymous feedback from current and past Fellows of the TTIPO Fellowship program and stakeholders in TTIPO and to better understand the experience Fellows have under the program. The feedback collected from the survey will be used to improve the TTIPO fellowship program so that fellows will have an improved training experience.

DESCRIPTION OF RESPONDENTS:

The voluntary survey participants will be current and former TTIPO Fellows and TTIPO stakeholders who are familiar with the TTIPO Fellowship program.

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: Peter Tung

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 [ ] No

3. If Applicable, has a System or Records Notice 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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Private sector (TTIPO Stakeholders)	15	1	10/60	3
Private sector (Current Fellows)	10	1	10/60	2
Private sector (Past Fellows)	30	1	10/60	5
Totals	55	55		10

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Private sector (TTIPO Stakeholders)	3	$29	$87
Private sector (Current Fellows)	2	$30	$60
Private sector (Past Fellows)	5	$55	$275
Totals			$422

* Avg. of Actual rate

FEDERAL COST: The estimated annual cost to the Federal government is ___$620_____

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Technology Transfer and Patent Specialist	13/4	$106,668	0.005812		$620
Contractor Cost
Travel
Other Cost
Total					$620

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2018/DCB.pdf

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?

The survey participants will be current and former fellows of the NIAID Technology Transfer fellowship program and TTIPO stakeholders who voluntarily choose to respond to a web-based survey. The former fellows of the fellowship program will be limited to those who have been in the program within the past 5 years. The link to the survey will be emailed to all current and former fellows and TTIPO stakeholders, with an invitation for voluntary participation.

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.

3