View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Usability and Needs Assessment of CDC's State, Tribal, Local, and Territorial Gateway Website	Agency IC Tracking Number:	0920-18CH

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
Form and Instruction	n/a	STLT Gateway Website Assessment Questionnaire	Attachment C Questionnaire Information Collection Instrument Web Version.docx		Yes	Yes	Fillable Fileable
Other-Reference document: WORD version of Web Quesionnaire Content			Attachment B Questionnaire Information Collection Instrument MS Word Version.docx		No		Paper Only
Form and Instruction	n/a	Card Sorting Assessment Instrument for the STLT Gateway	Attachment E Card Sorting Information Collection Instrument.pdf		Yes	Yes	Fillable Fileable
Other-Reference document: WORD version of Card Sorting Instrument Content			Attachment D Card Sorting Information Collection Instrument MS Word Version.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,913	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	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	2,913	0	2,913	0	0	0
Annual IC Time Burden (Hours)	576	0	576	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement Part A	UX-OSTLTS-SSA.docx	10/18/2017
Supporting Statement Part B	UX-OSTLTS-SSB.docx	10/18/2017
Screenshot of the STLT Gateway	Attachment A STLT Gateway Screenshot.pdf	10/18/2017
Method Used to Estimate Average Hourly Wage	Attachment F Calculating Average Hourly Wages for STLT Health Professional Respondent Burden (for Table A-12).docx	10/18/2017
Questionnaire Invitation	Attachment G Questionnaire Invitation.docx	10/18/2017
Questionnaire Reminder	Attachment H Questionnaire Reminder.docx	10/18/2017
Card Sorting Invitation	Attachment I Card Sorting Invitation.docx	10/18/2017
Card Sorting Reminder	Attachment J Card Sorting Reminder.docx	10/18/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.