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Bundled Website Usability Testings #1 (ASA24) and #2 (GEM)
Questionnaire Cognitive Interviewing and Pretesting (NCI)
OMB: 0925-0589
IC ID: 198056
OMB.report
HHS/NIH
OMB 0925-0589
ICR 201302-0925-007
IC 198056
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0589 can be found here:
2015-11-12 - No material or nonsubstantive change to a currently approved collection
2014-04-30 - Revision of a currently approved collection
Documents and Forms
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:
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 %
Requested
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
198
0
0
0
0
198
Annual IC Time Burden (Hours)
107
0
0
0
0
107
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.