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

Forms and Documents

Document Name	Status
FSILTU Language Test Score Feedback Form Form and Instruction	New
Form Survey FSIEX Customer Relationship Survey Form and Instruction	New
FSI LTU Language Test Score Report Feedback Form Form	New
Personal Safety & Security Questionaire Form and Instruction	New
Online Passport Renewal Survey - Limited Release Users.docx Justification for No Material/Nonsubstantive Change	2021-12-21
Generic Clearance Submission Template.docx Supplementary Document	2020-12-22
Survey Clearance Submission OMB Control Number 1405-0193.docx Supplementary Document	2018-04-17
Clearance Submission Template- Former Consular Fellows.doc Supplementary Document	2018-04-17
Webinars SS.docx Supplementary Document	2018-04-17
Beta Testing SS.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_Foreign Press Center Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs Product Use Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Simulation Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Front End Evaluation Interview Guide.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Exhibit User Tester Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Audience Survey.doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_USDC Audience Experience with Exhibits .doc Supplementary Document	2018-04-17
Generic Clearance Submission_Bureau of Public Affairs_Office of Public Engagement Survey.doc Supplementary Document	2018-04-17
State Kiosk - Generic Clearance Submission Template State Kiosk Survey (6-2015).pdf Supplementary Document	2018-04-17
National Visa Center - Generic Clearance Submission Template (NVC 6-2015).pdf Supplementary Document	2018-04-17
PPT Feedback - Generic Clearance Submission Template PPT Survey (4-2015).pdf Supplementary Document	2018-04-17
Feedback Survey_SV-2016-0002.pdf Supplementary Document	2018-04-17
Generic Clearance Submission DTAG Questionnaire.doc Supplementary Document	2018-04-17
Nonimmigrant Visa - Generica Clearance Submission.pdf Supplementary Document	2018-04-17
ACS - Generic Clearance Submission Template ACS (4-2015) survey.pdf Supplementary Document	2018-04-17
Immigrant Visa - Generic Clearance Submission Template Immigrant Visa Survey (7-2015).pdf Supplementary Document	2018-04-17
Legal Authorities for Customer Service Surveys - Copy.docx Supplementary Document	2020-12-22
Final -Supporting Statement for Generic Clearance.docx Supporting Statement A	2020-12-22
Part B - Supporting Statement for Paperwork Reduction Act Generic Information Collection Submissions for.docx Supporting Statement B	2017-06-27

IC Document Collections

IC ID	Document Title	Status
255191	FSILTU Language Test Score Feedback Form Form and Instruction	New
255190	FSIEX Customer Relationship Survey Form and Instruction	New
255189	FSI LTU Language Test Score Report Feedback Form Form	New
255188	Personal Safety & Security Questionaire Form and Instruction	New

ICR Details

OMB Control No: 1405-0193	ICR Reference No: 202208-1405-001
Status: Received in OIRA	Previous ICR Reference No: 202112-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/05/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2024
Responses	2,000,000	2,000,000
Time Burden (Hours)	116,667	116,667
Cost Burden (Dollars)	0	0

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Abstract: The information collection activity will collect qualitative customer feedback in an efficient, timely manner, in accordance with the Administration's commitment to improving service delivery. This qualitative feedback will provide insights into customer perceptions, experiences and expectations, provide an early warning of issues with service, or focus attention on areas where communication, training or changes in operations might improve delivery of products or services. These collections will allow for ongoing, collaborative and actionable communications between the Agency and its customers. It will also allow feedback to contribute directly to the improvement of program management.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: SETTING CUSTOMER SERVICE STANDARDS
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 42966	07/15/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 81551	12/06/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
FSI LTU Language Test Score Report Feedback Form	NA	Survey
FSIEX Customer Relationship Survey	Survey	N/A
FSILTU Language Test Score Feedback Form	NA, NA	Survey ,   Exit Survey
Personal Safety & Security Questionaire	N/A	Survey

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,000,000	2,000,000	0	0	0	0
Annual Time Burden (Hours)	116,667	116,667	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $750,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/05/2022

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