Information Collection

Consumer Response Intake Form Improvement Study

IC 213163 under ICR 201307-3170-002 · OMB 3170-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0042 can be found here:

Documents and Forms

Document Name Document Type
2014_9_18_Screening Questionnaire for Study Participation ICR 3170-0042_Revised.pdf Other-Screener
CR1_UX Study_Informed Consent_2014-9-16.pdf Other-Informed Consent
IC 3170-0042 Study CR1_Moderator's Guide_2014-9-15.pdf Other-Moderator's Guide
IC Form 3170-0042 Usability Testing Screening Questionnaires and Study Revised.pdf IC Form CR UX Study IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Response Intake Form Improvement Study	Agency IC Tracking Number:	TI 10307

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Informed Consent	CR1_UX Study_Informed Consent_2014-9-16.pdf	Yes	Yes	Fillable Fileable
Other-Moderator's Guide	IC 3170-0042 Study CR1_Moderator's Guide_2014-9-15.pdf	Yes	Yes	Fillable Fileable
Other-Screener	2014_9_18_Screening Questionnaire for Study Participation ICR 3170-0042_Revised.pdf	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title: CFPB Consumer Education and Engagement Records	FR Citation: 77 FR 60382

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	302	302
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
IC Form CR UX Study	IC Form 3170-0042 Usability Testing Screening Questionnaires and Study Revised.pdf	09/18/2014

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