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

Forms and Documents

Document Name	Status
Form SV-2014-0001 Premier Acceptance Facility Survey Form and Instruction	New
Form SV-2013-0004 Outreach Event Customer Satisfaction Comment Card Form and Instruction	New
Form SV-2013-0003 American Citizens Services Customer Service Satisfaction Survey Form and Instruction	New
Form SV2012-0001 OFM Customer Satisfaction Survey Form and Instruction	New
Form SV2011-0022 Visa Applicant Satisfaction Survey Form and Instruction	Unchanged
Form SV2011-0023 Argentine Exchange Alumni Survey Form	Unchanged
Justification for Non-substantive change (1405-0193) 7-2011.doc Justification for No Material/Nonsubstantive Change	2011-07-25
Generic Clearance Submission Template.doc Supplementary Document	2011-04-22
Supporting Statement Part B.doc Supporting Statement B	2011-03-16
EO 12862 SETTING CUSTOMER SERVICE STANDARDS.txt Supplementary Document	2011-03-16
Supporting Statement DoS Fast Trak Customer Service Surveys VERSION 2.docx Supporting Statement A	2011-03-31

IC Document Collections

IC ID	Document Title	Status
210887	Premier Acceptance Facility Survey Form and Instruction	New
208399	Outreach Event Customer Satisfaction Comment Card Form and Instruction	New
206429	American Citizens Services Customer Service Satisfaction Survey Form and Instruction	New
201289	OFM Customer Satisfaction Survey Form and Instruction	New
198037	Visa Applicant Satisfaction Survey Form and Instruction	Unchanged
197930	Argentine Exchange Alumni Survey Form	Unchanged

ICR Details

OMB Control No: 1405-0193	ICR Reference No: 201202-1405-005
Status: Historical Active	Previous ICR Reference No: 201107-1405-011
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
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: 03/13/2012
	Date Received in OIRA: 02/21/2012
Terms of Clearance: Previous terms of clearance remain in effect.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	05/31/2014	05/31/2014
Responses	75,000	0	75,000
Time Burden (Hours)	18,750	0	18,750
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the Agency 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 the Agency's programs.

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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:
	75 FR 245	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 47	03/10/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Argentine Exchange Alumni Survey	SV2011-0023	Argentine Exchange Alumni Survey
Outreach Event Customer Satisfaction Comment Card	SV-2013-0004	Outreach Event Customer Satisfaction Comment Card
Premier Acceptance Facility Survey	SV-2014-0001	Premier Acceptance Facility Survey
OFM Customer Satisfaction Survey	SV2012-0001	OFM Customer Satisfaction Survey
Visa Applicant Satisfaction Survey	SV2011-0022	Visa Applicant Satisfaction Survey
American Citizens Services Customer Service Satisfaction Survey	SV-2013-0003	American Citizens Services Customer Service Satisfaction Survey

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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	75,000	75,000	0	0	0	0
Annual Time Burden (Hours)	18,750	18,750	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: Burden change due to new collection submission.

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Annual Cost to Federal Government: $0

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

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: 02/21/2012

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