Information Collection

National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study

IC 220867 under ICR 201407-0920-003 · OMB 0920-1027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study	Form and Instruction
National Center for HIV/AIDS, Viral Hepatitis, STD and T Att1_ ScreenshotstNCHHSTPUsabilityTestQuest.docx	Form and Instruction
RequestTemplate NCHHSTP Website Redesign.docx GenIC Request	IC Document
Survey Service DeliveryChecklist.docx GenIC Checiklist	IC Document

IC Title:

National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study

Agency IC Tracking Number:

16ZT

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 and Instruction	NA	National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) Usability Study	Att1_ ScreenshotstNCHHSTPUsabilityTestQuest.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request	RequestTemplate NCHHSTP Website Redesign.docx	04/04/2016
GenIC Checiklist	Survey Service DeliveryChecklist.docx	04/04/2016

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