Generic Testing Clearance Form EIA112

Request for Approval under the “Generic Clearance for Questionnaire Testing and Research” (OMB Control Number: 1905-0186)

TITLE OF INFORMATION COLLECTION:

EIA-112 Usability Testing

PURPOSE:

EIA-112 is an annual survey that collects information on the number of monthly natural gas and electric service final notices, disconnections, and reconnections for bill non-payment across residential customers. More specifically, the annual form asks respondents to report monthly data on final notices, disconnections, and reconnections for bill non-payment for the previous 12 months. Data are collected from the universe of respondents that provide information on electric and natural gas service.

To improve data quality and enhance the respondent experience, EIA would like to conduct usability testing for the EIA-112 web instrument. The usability testing will evaluate respondents’ experiences and explore opportunities for improvement of the web instrument. These usability interviewers will use a semi-structured interview guide, which may be modified slightly based on information learned during the interviews.

DESCRIPTION OF RESPONDENTS:

Respondents from the Residential Utility Disconnections Survey (EIA-112) will participate in usability interviews.

TYPE OF COLLECTION: (Check one)

[ ] Field Testing [ ] Cognitive Interviews

[x ] Usability Testing [ ] Focus Groups

[ ] Pilot Surveys [ ] Other:

[ ] Respondent Debriefings

CERTIFICATION:

I certify the following to be true regarding the proposed collection of information:

1. It is necessary for the proper performance of agency functions.

2. It avoids unnecessary duplication.

3. It reduces burden on small entities.

4. It uses plain, coherent, and unambiguous language that is understandable to respondents.

5. Its implementation will be consistent and compatible with current reporting and recordkeeping practices.

6. It indicates the retention periods for recordkeeping requirements.

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

   1. Why the information is being collected;

   2. Use of information;

   3. Burden estimate;

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

   5. Nature and extent of confidentiality; and

   6. Need to display currently valid OMB control number

8. 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.

9. It uses effective and efficient statistical survey methodology (if applicable).

10. It makes appropriate use of information technology.

Name: Gerson D Morales

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

Personally Identifiable Information:

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

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

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

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Y [ x] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
EIA-112 Usability Interviews	20 Respondents	60 minutes	20 hours
	1500 non-respondents	1 minute	25 hours
Totals	1520 Respondents	--	45 hours

ESTIMATE OF RESPONDENT BURDEN HOURS AND COST – The burden to respondents is 45 hours and the cost to the respondents is estimated to be ($94.99 * 45) = $ 4,274.55.

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

Activity	Hours
Drafting Protocol	40 hours
Recruiting and Conducting Interviews	30 hours
Analyzing Results / Report Writing	160 hours

230 hours * $94.99 (FTE hourly pay rate) = $ 21,847.70

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?

Contact information for participants will be from the existing EIA-112 sample. There is a total of 2,833 entities in the frame for the EIA-112. EIA will send email invitations to up to 1,500 respondents that are in sample for EIA-112. The email invitation will ask respondents if they would be willing to participate in a 60-minute usability interview. EIA will interview up to 20 respondents. An effort will be made to recruit diverse entities, including single state and multistate providers and different energy types (e.g., gas only, electric only, gas and electric), EIA will provide respondents with an EIA-112 webform that will be used for testing purposes. The respondents will only provide mock data, and the data collected will not be used for statistical purposes as the objective of this usability project is to observe the functionality of the form. Respondents will be asked if EIA staff can observe them completing this webform. Following the observation, respondents will be asked concurrent and retrospective probes on their experience. The interviews will be conducted remotely using Microsoft Teams. If consent is given, the interviews will be recorded to assist in note-taking.

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, Explain: Video Conferencing

2. Will interviewers or facilitators be used? [ x] Yes [ ] 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 Questionnaire Testing and Research”

(OMB Control Number: 1905-0186)

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. 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 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.

Submit all instruments, instructions, and scripts are submitted with the request.

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