Information Collection

Bundled Website Usability Testings #1 (ASA24) and #2 (GEM)

IC 198056 under ICR 201302-0925-007 · OMB 0925-0589.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0589 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Bundled Website Usability Testings #1 (ASA24) and #2 (GEM)	Form and Instruction
1 #1_ASA 24 Screener and Guide #1 Attach 1A and 1C Screener & Guide.docx	Form and Instruction
2 #2_GEM Attach 2C 2D Survey and Guide #2_Attach 2C 2D_Survey and Guide_GEM_FINAL.docx	Form and Instruction
#1 Justif Memo Attach 1B 1D_5-18-2011.doc #1 Justif Memo Attach 1B 1D_5-18-2011	IC Document
Memo to OMB_Key To Bundled #1 and #2.doc Memo to OMB_Key To Bundled #1 and #2	IC Document
Gen IC Forms #1 and #2_ASA-24 & GEM Usability Testing.doc Gen IC Forms #1 and #2_ASA-24 & GEM Usability Testing	IC Document
#2_Justifi Memo Attach 2A 2B_GEM_FINAL.docx #2_Justifi Memo Attach 2A 2B_GEM_FINAL	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Bundled Website Usability Testings #1 (ASA24) and #2 (GEM)

Agency IC Tracking Number:

IC Status: Modified

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 and Instruction	1	#1_ASA 24 Screener and Guide	#1 Attach 1A and 1C Screener & Guide.docx		Yes	No	Fillable Printable
Form and Instruction	2	#2_GEM Attach 2C 2D Survey and Guide	#2_Attach 2C 2D_Survey and Guide_GEM_FINAL.docx		Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: SORN #09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"

FR Citation: 67 FR 60743

Number of Respondents: 198

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	198	198
Annual IC Time Burden (Hours)	107	107
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
#1 Justif Memo Attach 1B 1D_5-18-2011	#1 Justif Memo Attach 1B 1D_5-18-2011.doc	02/27/2013
Memo to OMB_Key To Bundled #1 and #2	Memo to OMB_Key To Bundled #1 and #2.doc	02/27/2013
Gen IC Forms #1 and #2_ASA-24 & GEM Usability Testing	Gen IC Forms #1 and #2_ASA-24 & GEM Usability Testing.doc	02/27/2013
#2_Justifi Memo Attach 2A 2B_GEM_FINAL	#2_Justifi Memo Attach 2A 2B_GEM_FINAL.docx	02/27/2013

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