Form 1 Applicant survey

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB#: 0925-0648 ExpDate:03/2018)
TITLE OF INFORMATION COLLECTION:
CSR Website Redesign Novice Applicants & Reviewer Interviews
PURPOSE:
Applicants and reviewers are the two primary audiences for the Center for Scientific Review
(CSR). A series of questions have been designed to identify participant’s knowledge of CSR and
their role in the application and review process. These questions will inform our design and
development of the CSR Website Redesign to improve communication and service.
DESCRIPTION OF RESPONDENTS:
Our target audience is novice applicants. We believe they know the least about the process and
need the most help. By understanding their challenges with the application process we can make
informed decisions on how to better label and structure information to help them.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[x] Usability Testing (e.g., Website or Software
[ ] Focus Group

[ ] Customer Satisfaction Survey
[ ] Small Discussion 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:____Kristin Kramer_________________________________________
To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [ ] Yes X No
2. If Yes, is the information that will be collected included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ ] No
3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? [ ] Yes [x] No

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ESTIMATED BURDEN HOURS and COSTS
Category of Respondent

No. of Respondents

No. of Responses per
Respondent

Private Sector-Applicants
Private Sector-Reviewers
Totals

5
5
10

5
5
10

Category of Respondent

Total Burden
Hours
5
5
10

Hourly Wage Rate*

Private Sector-Applicants
Private Sector-Reviewers
Totals

$36.13
$36.13

Time per
Response
(in hours)
1
1

Total
Burden
Hours
5
5
10

Total Burden
Cost
$180.65
$180.65
$361.30

*bls.gov 19-1029 Biological Scientists, All Other – Median National Estimate
FEDERAL COST: The estimated annual cost to the Federal government is $1,848.78

Staff
Federal Oversight

Contractor Cost

Grade/Step
15/6

Salary
$119,756

% of
Effort
0.005

$125.00 hr 10

Fringe (if
Total Cost to
applicable) Gov’t
598.78

$1,250.00
0
0

Travel
Other Cost

$1,848.78

Total

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

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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?
Applicants
A national list of subjects will be used. This list will be comprised of new faculty
members at universities within the U.S. specifically biologists. We will then cross check
against our database (QVR within IMPAC II) to see if they are new to NIH, if they have
submitted for funding grants, or if they have reviewed. Five (5) subjects will be recruited
to get an unbiased representation of the United States.
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[ ] Web-based or other forms of Social Media
[x] Telephone
[ ] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [X] Yes [] No

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