One Pager

Request for Approval under the _Generic Clearance for the Collection of Routine Customer Feedback_ (OMB Control Number 0704-0553).docx

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

One Pager

OMB: 0704-0553

Document [docx]
Download: docx | pdf


Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0704-0553)

Shape1 TITLE OF INFORMATION COLLECTION: Comment Card for soliciting feedback from people attending the Heartland Band 2023 SOUNDS of the SEASON musical production


PURPOSE:

Receive feedback on customer satisfaction after attending our Sounds of the Season musical production that serves as a major part of the USAF Heartland of America Band’s overall community outreach service/mission. The second purpose is to learn how our customers become aware of our production/service so that we may gauge the effectiveness of our advertising strategy and expenditures. Both purposes are intended meet evaluation procedures as stated in DoDI 5410-19, Vol 4, Para. 3.4. RETURN ON INVESTMENT.


DESCRIPTION OF RESPONDENTS:

Attendees of our musical production to be presented 15-17 Dec 2023. We anticipate a demographic of civilians, veterans of military and federal government service, and members of the Federal Government (Civilians and Military) as well as Federal Contractors.


TYPE OF COLLECTION: (Check one)

[X] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus 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: Douglas A. Roe, GS-11, DAF

Director of Operations

USAF Heartland of America Band

Offutt AFB NE


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, 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? [ ] Yes [X] No


BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

Private Sector

110

3 minutes


Federal Government (Military & Civilian)

40

3 minutes


Totals

150

450 minutes

7.5


FEDERAL COST: The estimated annual cost to the Federal government is $311.25.


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? [ ] Yes [X] 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?


People attending our community outreach service concerts may provide feedback via an online ICE Comment Card, which they may access via either a QR Code or URL that will be included on a printed program that they receive upon being seated at our concerts. They will be invited to participate; participation is voluntary.


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: ICE Comment Card

  1. Will interviewers or facilitators be used? [ ] Yes [ X] No



RECORDS DISPOSITION SCHEDULE:


COMMUNICATION METHODS USED TO REQUEST FEEDBACK via the Comment Card:

-QR Code and URL to access the comment card will be printed on programs distributed to audience members attending our musical production/service.

3

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2025-05-29

© 2025 OMB.report | Privacy Policy