CBAMS Cognitive and Usability Interviews

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⚠️ Notice: This information collection may be referencing outdated material.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 CBAMS Cognitive and Usability Interviews Form and Instructi
1 Paper Questionnaire Attachment 1 CBAMS_paper questionnaire.pdf Form and Instruction
2 Demographics Questionnaire Attachment 5 Demographic Questionnaire.docx Form and Instruction
3 Usability Satisfaction Questionnaire Attachment 6 Satisfaction Questionnaire.docx Form and Instruction
2020 CBAMS OMB Memo_05242017.docx OMB Memo IC Document
Attachment 2 Cognitive Interview Protocol Paper.docx Cognitive Interview Protocol IC Document
Attachment 3 Usability Testing Protocol.docx Usability Interview Protocol IC Document
Attachment 4 Consent Form-2020 CBAMS.docx Consent Form IC Document
Attachment 7 Mailing Materials.docx Mailing Materials IC Document
Attachment 8 CBAMS Usability Debriefing Slides.pptx Usability Debreifing Slides IC Document

Information Collection (IC) Details

IC Title:	CBAMS Cognitive and Usability Interviews	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	1	Paper Questionnaire	Attachment 1 CBAMS_paper questionnaire.pdf	No	Paper Only
Form and Instruction	2	Demographics Questionnaire	Attachment 5 Demographic Questionnaire.docx	No	Paper Only
Form and Instruction	3	Usability Satisfaction Questionnaire	Attachment 6 Satisfaction Questionnaire.docx	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	2020 CBAMS OMB Memo_05242017.docx	05/24/2017
Cognitive Interview Protocol	Attachment 2 Cognitive Interview Protocol Paper.docx	05/24/2017
Usability Interview Protocol	Attachment 3 Usability Testing Protocol.docx	05/24/2017
Consent Form	Attachment 4 Consent Form-2020 CBAMS.docx	05/24/2017
Mailing Materials	Attachment 7 Mailing Materials.docx	05/24/2017
Usability Debreifing Slides	Attachment 8 CBAMS Usability Debriefing Slides.pptx	05/24/2017

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