View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Tobacco Product Surveillance Team (TPST) Safety Reporting Portal (SRP) User Interface/User Experience (UI/UX) Testing Plan
Agency IC Tracking Number:
CTP
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
Other-Attachment 1 - Recruitment and Reminder Emails
Att 1 - Recruitment and Reminder Emails Clean.docx
Yes
Yes
Printable Only
Other-Attachment 2 - Phone Screener
Att 2 - Phone Screener Clean.docx
No
Printable Only
Other-Attachment 3 - Consent Forms
Att 3 - Consent Forms Clean.pdf
Yes
Yes
Fillable Fileable
Other-Attachment 4 - Group Discussion Moderator Guide
Att 4 - Group Discussion Moderator Guide Clean.docx
Yes
No
Printable Only
Other-Attachment 5 - UI/UX Interview Moderator Guide
Att 5 - UI-UX Interview Moderator Guide Clean.docx
Yes
No
Printable 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:
108
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
108
0
108
0
0
0
Annual IC Time Burden (Hours)
77
0
77
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
OMB Memo 0697 - SRP Tobacco Product Report User Testing Clean 11-09-23.docx
11/09/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.