Information Collection

Usability Testing for the National

IC 225851 under ICR 201510-0923-001 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 17wl Usability Testing for the National	Form and Instruction
Attachment B - Discussion Guide (remote and in-person).docx	Instruction
17wl Attachment A - Respondent Screeners Attachment A - Respondent Screeners.docx	Form and Instruction
0923-0047 NCEH-ATSDR Generic Clearance EPHTN.pdf 0923-0047 NCEH-ATSDR Generic Clearance EPHTN	IC Document

IC Title:

Usability Testing for the National

Agency IC Tracking Number:

17WL

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	17wl	Attachment A - Respondent Screeners	Attachment A - Respondent Screeners.docx		Yes	Yes	Fillable Printable
Instruction			Attachment B - Discussion Guide (remote and in-person).docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 136

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	136	136
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0923-0047 NCEH-ATSDR Generic Clearance EPHTN	0923-0047 NCEH-ATSDR Generic Clearance EPHTN.pdf	02/28/2017

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