Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Fast Track)

Forms and Documents

Document Name	Status
Justification for Change Request.doc Justification for No Material/Nonsubstantive Change	2011-07-26

IC Document Collections

IC ID	Document Title	Status
211947	Retirement Research Consortium (RRC) Survey Other-survey	New
211553	State Court Adult Guardianship Practices Online Survey (ACUS Survey) Other-Survey	New
211203	Ticket to Work (TTW) Program Outreach Materials Interviews Other-Survey	New
211042	Two Qualitative Customer Satisfaction Surveys: Change of Address Notice Focus Group and EBB; OIG Semiannual Report to Congress Survey Other-survey	New
210690	Webinar and Webcast Survey Other-survey	New
210382	Two Customer Satisfaction Suveys - Focus Group National Communications Campaign and Field Office Intercept National Communications Campaign Other-survey focus group	New
210246	Two Customer Satisfaction Surveys - Disability Awarness Campaign Media Survey and Disability Program Feedback Survey Other-Survey	New
209916	Customer Satisfaction Survey - eServices Kiosks Other-Survey	New
208756	Disability Awareness Survey Other-Survey Sheet	New
207535	Retirement Research Consortium (RRC) Conference Survey Other-survey	New
207204	SSA Nationwide Billboard Campaign - Other-Survey	New
206213	Two Customer Satisfaction Surveys - OIG Website and OIG Semiannual Report to Congress Other-Survey	New
206072	SSA Mobile Website Survey Other-survey	New
205509	Electronic Payment Customer Satisfaction Survey Other-survey	New
205326	Jackson Federal Bulding Access Survey Questionnaire Other-questionnaire	New
204831	Two Customer Satisfaction Surveys Other-survey	New
204339	Survey - SSA Redesigned Home Page Other-survey	New
204171	Customer Satisfaction Survey - EBB PROMISE Other-Survey	New
202995	RRC Conference Survey Other-Survey	New
202138	OAG Contractor Survey Other-Survey	New
201803	Appointed Representative Survey (Interview) Other-Survey	New
201495	Survey - Section 504 Self-Evaluation Survey Other-Survey	New
200949	Ticket to Work (TTW) Program Focus Group Other-focus group	New
200795	Two Customer Satisfaction Surveys (MySSAccess Focus Group and PCAP Survey for SSA Alumni) Other-survey	New
200577	Two Customer Satisfaction Surveys - Registration, Personalized Portal, and the Online Social Security Statement Other-survey	New
200073	ANI Reroute to WBDOC Project Other-Survey Telephone Script	New
199701	Video Remote Interpreting Electronic Bulletin Board Discussion Group Other-Survey	New
199649	FAQ Web Pages and Alternative Designs Focus Group Other-focus group	New
198658	RRC Survey Other-survey	New
198480	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Other-Survey Template	Removed

ICR Details

OMB Control No: 0960-0788	ICR Reference No: 201107-0960-009
Status: Historical Active	Previous ICR Reference No: 201107-0960-003
Agency/Subagency: SSA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Fast Track)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/2011
	Date Received in OIRA: 07/26/2011
Terms of Clearance: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2014	07/31/2014	07/31/2014
Responses	4,812,504	0	4,812,504
Time Burden (Hours)	438,375	0	438,375
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable SSA to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with SSA's programs.

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Authorizing Statute(s): None

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:
	75 FR 80542	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 15027	03/18/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 29

IC Title	Form No.	Form Name
Ticket to Work (TTW) Program Focus Group
Customer Satisfaction Survey - EBB PROMISE
Two Customer Satisfaction Surveys - Disability Awarness Campaign Media Survey and Disability Program Feedback Survey
Two Customer Satisfaction Surveys - Registration, Personalized Portal, and the Online Social Security Statement
Appointed Representative Survey (Interview)
SSA Mobile Website Survey
Retirement Research Consortium (RRC) Survey
Retirement Research Consortium (RRC) Conference Survey
Jackson Federal Bulding Access Survey Questionnaire
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OAG Contractor Survey
Disability Awareness Survey
State Court Adult Guardianship Practices Online Survey (ACUS Survey)
Two Qualitative Customer Satisfaction Surveys: Change of Address Notice Focus Group and EBB; OIG Semiannual Report to Congress Survey
Two Customer Satisfaction Surveys
Survey - SSA Redesigned Home Page
ANI Reroute to WBDOC Project
Survey - Section 504 Self-Evaluation Survey
Customer Satisfaction Survey - eServices Kiosks
Ticket to Work (TTW) Program Outreach Materials Interviews
Webinar and Webcast Survey
RRC Survey
FAQ Web Pages and Alternative Designs Focus Group
Two Customer Satisfaction Surveys - OIG Website and OIG Semiannual Report to Congress
Two Customer Satisfaction Suveys - Focus Group National Communications Campaign and Field Office Intercept National Communications Campaign
RRC Conference Survey
Video Remote Interpreting Electronic Bulletin Board Discussion Group
Two Customer Satisfaction Surveys (MySSAccess Focus Group and PCAP Survey for SSA Alumni)
Electronic Payment Customer Satisfaction Survey
SSA Nationwide Billboard Campaign -

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ICR Summary of Burden

	Total Approved	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	4,812,504	4,812,504	0	0	0	0
Annual Time Burden (Hours)	438,375	438,375	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: $131,204

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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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: 07/26/2011

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