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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Census Test Usability Testing Addendum
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Enclosure 2 Mailing Materials.pdf
No
Fillable Fileable
Form and Instruction
1
Instrument Debriefing Screens
Enclosure 3 Placeholder screens for debriefing.pptx
No
Fillable Fileable
Form and Instruction
2
Demographics Questionnaire
Enclosure 4 2017 CT Demographics.docx
No
Fillable Fileable
Form and Instruction
3
Mobile Experience Questionnaire
Enclosure 5 2017 CT Mobile Experience Questionnaire.docx
No
Fillable Fileable
Form and Instruction
4
Satisfaction Questionnaire
Enclosure 6 2017 CT Satisfaction questionnaire.docx
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
216
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
216
0
216
0
0
0
Annual IC Time Burden (Hours)
384
0
384
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
OMB Letter Addendum.docx
06/11/2018
Protocol
Enclosure 1 Protocol.docx
06/11/2018
Screener
Enclosure 7 Screener.docx
06/11/2018
Consent Form
Enclosure 8 RTI Consent Form.docx
06/11/2018
Login Card
Enclosure 9 Login Card.docx
06/11/2018
Approved memo from 2017 testing
Enclosure 10 Approved memo from 2017 testing.docx
06/11/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.