Submission Form

PAPERWORK REDUCTION ACT

NASA GENERIC CLEARANCE SUBMISSION

OMB CONTROL NUMBER 2700-0127

This form should be used if you are submitting a collection of information for approval under the NASA generic clearance assigned OMB control number 2700-0127. Mail this form, supplemental documentation, the collection instrument, and any additional documentation to: Walter Kit, NASA Paperwork Reduction Act Desk Officer, NASA Headquarters, Washington D.C. 20546, or via e-mail to [email protected].

If the collection does not satisfy the requirements of the program clearance, you should follow the regular PRA clearance procedures described in 5 CFR 1320.

NASA Subagency:

NASA Education

Title (Please be specific):

NASA Education Usability Data Collections

Burden Hour/Cost Estimates

Number of respondents: 524 Annual Responses Approved by OMB: 600

Total Burden Hours: 524 Annual Burden Hours Approved by OMB: 900

Cost to participant: 0

Cost to NASA: $33,840

Agency Contact (person who can best answer questions about the content of the submission)

Name: Dawn Gaddis

Phone: 256-544-0167

Certification:

The collection of information requested by this submission meets the requirement of the OMB approval for OMB control number2700-0127.

Signature of OMB Program Official

___________________________________________________________________________

Date

_____________________________

Signature of NASA Paperwork Clearance Officer

____________________________________________________________________________

Date

_____________________________

Instructions for Submission under NASA Generic Clearance for Usability Data Collections

1. Consult with the NASA Paperwork Reduction Act Desk Officer to confirm that your collection meets the conditions for submission under this clearance.

2. Link documentation for individual collections to information in the original Supporting Statement.

3. Complete and sign the cover sheet. Note: Any questions during the review about the survey will addressed directly to the person listed as the Agency Contact.

4. Give the cover sheet, supplemental documentation including the data collection instrument, and any other helpful information to the NASA Paperwork Reduction Act Desk Officer, who will review the materials, sign the cover sheet and send the package to OMB. The Desk Officer will be notified when the collection is approved under OMB Control Number2700-0127.