Cognitive Testing of PPI Data Collection Forms

Cognitive and Psychological Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Document Name Document Type
Form Attachments Cognitive Testing of PPI Data Collection Forms Form and Instruction
Attachments Cognitive Testing Protocol and Form PPI Forms Test Cognitive Protocol.docx Form and Instruction
OMB Clearance for Form Usability Test.docx Note to Reviewer IC Document

Information Collection (IC) Details

IC Title:	Cognitive Testing of PPI Data Collection Forms	Agency IC Tracking Number:	21207

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	Attachments	Cognitive Testing Protocol and Form	PPI Forms Test Cognitive Protocol.docx		No		Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Note to Reviewer	OMB Clearance for Form Usability Test.docx	06/04/2012

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