Information Collection

CBAMS Cognitive and Usability Interviews

IC 226990 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

CBAMS Cognitive and Usability Interviews

Agency IC Tracking Number:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.