Information Collection

Web Diary Feasibility Test CE Diary

IC 202923 under ICR 201304-1220-004 · OMB 1220-0050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Web Diary Requirem Web Diary Feasibility Test CE Diary	Form and Instruction
Web Diary Requirem Web Diary Requirements Attachment D - Diary 2012 instrument requirements - Web Diary Test changes revised 2012-10.docx	Form and Instruction
Web Diary Screen S Web Diary Screen Shots Attachment E - Screen shots Web Diary 10-9-12.docx	Form and Instruction
Web Diary Screenin Web Diary Screening and Debriefing Questions Attachment F - Web Diary - Screening and Debriefing Questions.docx	Form and Instruction
Attachment C - WDF_study_overview 10.9.12.doc Web Diary Feasibility Study Overview	IC Document
Attachment G - Sampling plan.docx Attachment G - Sampling Plan	IC Document
Attachment H - Web Diary Usability Round 1 (Final - 5.17.2012).docx Attachment H - Web Diary Usability Round 1	IC Document
Attachment I - Web Diary Usability Round 2 (Final).docx Attachment I - Web Diary Usability Round 2	IC Document

IC Title:

Web Diary Feasibility Test CE Diary

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Web Diary Requirements	Web Diary Requirements	Attachment D - Diary 2012 instrument requirements - Web Diary Test changes revised 2012-10.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Web Diary Screen Shots	Web Diary Screen Shots	Attachment E - Screen shots Web Diary 10-9-12.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Web Diary Screening and Debriefing Questions	Web Diary Screening and Debriefing Questions	Attachment F - Web Diary - Screening and Debriefing Questions.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,750	1,750
Annual IC Time Burden (Hours)	535	535
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Web Diary Feasibility Study Overview	Attachment C - WDF_study_overview 10.9.12.doc	10/10/2012
Attachment G - Sampling Plan	Attachment G - Sampling plan.docx	08/15/2012
Attachment H - Web Diary Usability Round 1	Attachment H - Web Diary Usability Round 1 (Final - 5.17.2012).docx	08/15/2012
Attachment I - Web Diary Usability Round 2	Attachment I - Web Diary Usability Round 2 (Final).docx	10/10/2012

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