NSSRN Usability Evaluation

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⚠️ Notice: This information collection may be referencing outdated material.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 NSSRN Usability Evaluation Form and Instructi
1 Demographics Questionnaire Enclosure 2 Demographics.docx Form and Instruction
2 Debriefing Questions Enclosure 3 Debriefing Slides.pptx Form and Instruction
3 Satisfaction Questionnaire Enclosure 4 Satisfaction questionnaire.docx Form and Instruction
4 NSSRN Questionnaire Enclosure 6 NSSRN_18_080917_D20.pdf Form and Instruction
OMB letter - NSSRN_Final.docx OMB Memo IC Document
Enclosure 1 2018 NSSRN Protocol_Final Draft.docx Protocol IC Document
Enclosure 5 Additional Screener_NSSRN_Questions.docx Screener questions and Ads IC Document

Information Collection (IC) Details

IC Title:	NSSRN Usability Evaluation	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?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Demographics Questionnaire	Enclosure 2 Demographics.docx	No		Fillable Fileable
Form and Instruction	2	Debriefing Questions	Enclosure 3 Debriefing Slides.pptx	No		Fillable Fileable
Form and Instruction	3	Satisfaction Questionnaire	Enclosure 4 Satisfaction questionnaire.docx	No		Fillable Fileable
Form and Instruction	4	NSSRN Questionnaire	Enclosure 6 NSSRN_18_080917_D20.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	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	16	16
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	OMB letter - NSSRN_Final.docx	08/15/2017
Protocol	Enclosure 1 2018 NSSRN Protocol_Final Draft.docx	08/15/2017
Screener questions and Ads	Enclosure 5 Additional Screener_NSSRN_Questions.docx	08/15/2017

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