Generic Clearance for NCA, and IG Customer Satisfaction Surveys

Forms and Documents

Document Name	Status
2900-0571 justification Part B.doc Supporting Statement B	2006-12-05
2900-0571 justification.doc Supporting Statement A	2006-12-05

IC Document Collections

IC ID	Document Title	Status
42215	Generic Clearance for NCA, and IG Customer Satisfaction Surveys Other-IG CBOC Patient Survey	Modified

ICR Details

OMB Control No: 2900-0571	ICR Reference No: 200612-2900-008
Status: Historical Active	Previous ICR Reference No: 200606-2900-004
Agency/Subagency: VA	Agency Tracking No:
Title: Generic Clearance for NCA, and IG Customer Satisfaction Surveys
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/16/2007
	Date Received in OIRA: 12/06/2006
Terms of Clearance: Approved consistent with the following terms of clearance: OMB will review customer satisfaction and quality improvement surveys under this generic clearance - program evaluations will not be reviewed under the generic. VA shall maintain a running tally of approved burden hours used by each package under this generic. The Dept. will submit studies under the generic for review by OMB which will generally be conducted in approximately 10 days, however, OMB must affirmatively approve each package under the generic before VA begins information collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2010	36 Months From Approved	02/28/2007
Responses	29,650	0	30,090
Time Burden (Hours)	13,325	0	13,398
Cost Burden (Dollars)	0	0	0

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Abstract: The information will be used to improve the quality of VA services and help shape the direction and focus of specific programs and services.

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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:
	71 FR 178	09/14/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 234	12/06/2006
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Generic Clearance for NCA, and IG Customer Satisfaction Surveys

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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	29,650	30,090	0	-440	0	0
Annual Time Burden (Hours)	13,325	13,398	0	0	-73	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: The burden hour decrease is due to a change in the number of prospective survey participants.

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Annual Cost to Federal Government: $199,875

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 12/06/2006

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