Information Collection

DPDB Usability Studies

IC 210508 under ICR 201206-0915-002 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 DPDB Usability Studies	Form
1 Usability Testing Survey-Website Form Website Form.docx	Form
2 Usability Testing Survey-IQRS Form IQRS Form.docx	Form
Supporting Statement.docx Supporting Statment	IC Document

IC Title:

DPDB Usability Studies

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Usability Testing Survey-Website Form	Website Form.docx		Yes	Yes	Paper Only
Form	2	Usability Testing Survey-IQRS Form	IQRS Form.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	300	0	0	0	0	0
Annual IC Time Burden (Hours)	300	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statment	Supporting Statement.docx	02/20/2014

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