Approved Form DI-4011, Request for Approval Under the "DOI Generic Clearance for the Collection of Quantitative Feedback on Agen

0MB Control. No. 1090-00 11

DI-40 1 I (Rev. 07/20 18)
U. S. Department of the Interior

Expiration Date I 0/3 1/2021

REQUEST FOR APPROVAL UNDER THE
"DOI GENERIC CLEARANCE FOR THE COLLECTION OF
QUANTITATIVE FEEDBACK ON AGENCY SERVICE DELIVERY"

See Pa e 4 or Instructions on Com
Title of Information Collection

Pilot program for an eva luation guide for high potential sites and segments for the Santa Fe National Historic Trail
Purpose

The National Trails System Act (NTSA) tasks trail administrators with the responsibility of identifying high potential sites
and segments associated with National Historic Trails (NHT). It has been almost 30 years since the list of high potential
sites and segments was updated for the Santa Fe NHT; we need to collect more current information in order to
effectively administer this resource .
As defined by the NTSA, the term "high potential historic sites" includes historic sites related to the route, or sites in
close proximity, that provide opportunities to interpret the historic significance of the trail during the period of its major
use. The term "high potential route segments" means those segments of a trail which would afford high quality
recreation experience in a portion of the route having greater than average scenic values or affording an opportunity to
vicariously share the experience of the original users of a historic route .
We would like to pilot test an evaluation guide using the Santa Fe NHT as the testing site. The evaluation guide is
intended to assists trail administrators and trail partners when describing and documenting attributes that characterize
trails as high potential sites or segments. The goal of the pilot test is to create tool that trail administrators can use
when updating the list of high potential sites and segments for the Santa Fe NHT or other trails in the future. The
intent of the pilot program is to evaluate how effectively the guide can be for collecting and sharing data.
Description of Respondents

The respondent for this collection will be the trail partners (e.g., SHPO, THPO , trail associations, local
government, land owners, land managers, etc.) for the Santa Fe National Historic Trail. These long standing
partnerships are recognized as local experts on trail matters.

Type of Collection (Check One)

0

Customer Comment Card/Complaint Form

0 Usability Testing (e.g ., Website or Software

O

Customer Satisfaction Survey

O Small Discussion Group

O

Focus Group

!ii

Other: Pilot Study

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
ex erience with the ro ram in the future .

Typed Name of Requester

Signature

Jill Jensen

Date

01/07/2020
FOR USE BY ICC

Bureau ICCO

Signature

[ii
Recommend
□
Not Recommended

byPHADREAPONDS
PHADREA PONDS Digitallysigned
Date: 2020.01.07 13:45:47 -OTOO-

Date

Page 1 of 4

Dl-401 I (Rev. 07/201 8)
U.S. Department of the Interior

0MB Control. No. 1090-00 11
Expiration Date I 0/3 1/202 1

TO ASSIST REVIEW, PLEASE PROVIDE ANSWERS TO THE FOLLOWING QUESTIONS:
Personally Identifiable Information (Please consult with your Bureau/Office Privacy Act Officer)
1. Will you collect any personally identifiable information (see 0MB Circular No. A-130 for an explanation of this term)?
Ii] No D Yes If "Yes," please consult with your Bureau/Office Privacy Act Officer.
2. If "Yes", is the information to be collected included in records that are subject to the Privacy Act of 1974?
0 No D Yes
3. If applicable , has a System or Records Notice (SORN) been published?
□ No D Yes If "Yes," please provide the title and FR citation below:
FR Citation for SORN

Title of SORN :

Gifts or Payments (Please refer to 0MB guidance "Questions and Answers When Designing Survey_s for Information Collections')
Ii] No LJ Yes If
Is an incentive (e.g ., money or reimbursement of expenses, token of appreciation) provided to participants?
"Yes", please describe the incentive and provide a justification for the amount:

Federal Enterprise Architecture (FEA) Business Reference Model (Check only one "Line of Business" and one "Subfunction."
Refer to 0MB auidance "FEA Consolidated Reference Model Document Version 2.3")
Line of Business

□
□

□
□

I

Subfunction

Community and
Social Services
Defense and
National Security
Economic
Develooment

(Select One)

□

(Select One)

□

Energy

(Select One)

LJ General Science

I

Line of Business

(Select One)

Correctional
Activities
Disaster
Management

Subfunction
(Select One)

(Select One)

□
□

Education

(Select One)

Environmental
Manaaement

(Select One)

--

-

and Innovation

(Select One)

□

Health

(Select One)

□
□

Homeland Security

(Select One)

□

Income Security

(Select One)

lntelfigence
Ooerations

(Select One)

□

□
Iii
□

Law Enforcement

(Select One)

□

International Affairs
and Commerce
Litigation and
Judicial Activities

(Select One)
(Select One)

(Select One)
Recreational Resource ManagemerG □ Transportation
Workforce
(SelE;_0, One)
Manaqement
Burden Hour Calculation
Participation
Number of Annual
Number of
Total Annual
Time
Responses
Responses Each
Respondents
Category of Respondent
Natural Resources

Private Sector

E11

50

I

1

I

50

I

10 hours

Total Burden
Hours

I

500

Federal Cost: (Consult your Bureau/Office Information Collection Clearance Officer for assistance, if necessary)
The estimated annual cost to the Federal government is$ 19,385

, based on : (provide details below)

The estimated annual cost to the federal government is based on the assumption that it will take a GS-11 step 10 approximately 10
Using Salary table 2019 - AQ , we multiplied 5000 hours time $62.32 (the hourly rate of $38.95 times 1.6 (to account for
benefits)

Sample Response to Federal Cost Question:
"If we receive 20 submissions and it takes 30 minutes to process and implement each one , then the total burden is $322.40
assuming a GS-7 step 5 is processing the submissions. Please note, however, that this custom form is a tool meant to accept
submissions in a standard format rather than through the freeform submissions that would otherwise come in by personal email.
Thus the existence of this form actually saves the government money by standardizing submissions and decreasing the workload of
processing each one ."
Page 2 of 4

Dl-40 11 (Rev. 07/20 18)
U.S. Department of the Interior

0MB Control. No. 1090-00 1 I
Expiration Date 10/31 /2021

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the
following questions:
Selection of 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?
D No Ii Yes If "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 members of the Santa Fe Trail Association , a partner group for the Santa Fe NHT. The board of
directors for the association will invite chapters to participate in the workshop and field test. There are 16 chapters
within the association, we are anticipating that at least 50 members will participate.

METHODOLOGY: The pilot program will begin with a 30 minute workshop that will explain the intent of the study and
discuss the methods and criteria used to evaluate high potential sites. The remaining 30 minutes will be used to allow
the participants to select a site, fill out the evaluation matrix and return the package to the workshop leaders. A
discussion about the matrix will capture any changes that may be needed and ways to improve the guide. Our plan is to
conduct 10 workshops with no more than five (5) participants in each session.
OUTCOMES; The evaluation guide and matrix will be refined to increase efficiency and improve utility to ensure that
high potential site are appropriately identified .
Administration of the Instrument:

2. How will you collect the information? (Check all that apply)
[i] Web-based or other forms of Social Media
[i] Mail

D
D

Telephone

Iii

In-person

Other:

Use of Interviewers or Facilitators:

3. Will you use interviewers or facilitators?

D

No

Iii

Yes

PLEASE SUBMIT SURVEY INSTRUMENT, INSTRUCTIONS, AND SCRIPTS WITH '(OUR REQUEST.

Page 3 of 4