Mobile UI Design Framework for Survey Operations – Phase 1, Study 2

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Mobile UI Design Framework for Survey Operations – Phase 1, Study 2 Form and Instructi
1 Experimental Info Enclosure2 - Experimental info.docx Form and Instruction
2 Privacy Act Statement Enclosure3 - Privacy Act Statement.docx Form and Instruction
Addendum for IOE Mobile UI project v2.docx OMB Memo IC Document
Enclosure1 - Sample study plan.docx Study Plan IC Document
Enclosure4 - Consent Form.docx Consent Form IC Document

Information Collection (IC) Details

IC Title:	Mobile UI Design Framework for Survey Operations – Phase 1, Study 2	Agency IC Tracking Number:

IC Status: New

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	Experimental Info	Enclosure2 - Experimental info.docx		No		Fillable Fileable
Form and Instruction	2	Privacy Act Statement	Enclosure3 - Privacy Act Statement.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	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	180	180
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	Addendum for IOE Mobile UI project v2.docx	05/24/2017
Study Plan	Enclosure1 - Sample study plan.docx	05/24/2017
Consent Form	Enclosure4 - Consent Form.docx	05/24/2017

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