VBA OSE Fast Track Submission Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 2900-0770)

T ITLE OF INFORMATION COLLECTION:

Anonymous Online Questionnaire to Solicit Veteran Feedback on Veterans Benefits Administration Communications Materials

PURPOSE:

The Veterans Benefits Administration (VBA) plays a critical role in connecting Veterans with the benefits and services they have earned. VBA’s Office of Strategic Engagement (OSE) serves as the primary interface with these individuals through online engagement, providing Veterans with timely and appropriate information. Through this online, anonymous questionnaire, OSE seeks to collect data that can inform outreach decisions, improve existing communication materials, and enhance how VBA communicates with Veterans, service members, and their families.

DESCRIPTION OF RESPONDENTS:

The customer satisfaction questionnaire will be posted to VBA’s Facebook, Twitter, and Instagram channels making it available to nearly 730,000 social media followers. The questionnaire will also be sent to more than 5 million subscribers of VBA’s monthly email bulletin, the Veterans Benefits Newsletter. On average, approximately 1.2 million subscribers open the newsletter each month. Subscribers and followers include Veterans, service members, their families, and beneficiaries.

However, the online questionnaire platform limits the number of responses collected to 5,000 individuals per month. The questionnaire will be available to VBA’s social media followers in December 2020 and VBA’s newsletter subscribers in January 2021. Therefore, the burden (as detailed below) will be based on a total of 10,000 responses.

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: Amee Roberson, Director, VBA Office of Strategic Engagement_________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

The questionnaire gives respondents the option to voluntarily provide their email address if they are open to participating in future conversations about VBA communication materials. Completing this request is optional and would provide VBA with respondents’ low-risk PII that has already been volunteered by subscribing to VBA’s email bulletins. In the case of social media followers, all PII will be voluntarily provided through the online questionnaire itself. The PII collected would not be used or shared publicly.

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

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X] No

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
Individuals or Households	10,000	10 minutes	1,666.67
Totals	10,000	10 minutes	1,666.67

FEDERAL COST: The estimated annual cost to the Federal government is $0.00

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? [] Yes [X] 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?

Because the questionnaire will be sent to subscribers of OSE’s monthly newsletter and VBA’s social media followers, a customer list exists. However, the questionnaire will be sent to all subscribers and followers, not those who meet certain sample group criteria. Therefore, our sample will be randomized based on those who voluntarily respond to the questionnaire.

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

[X] Other, online questionnaire administered through the SurveyMonkey platform

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 Routine Customer Feedback”

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 (in minutes) 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 Respondents and the Participation Time then 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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