Information Collection

Cognitive Testing of Privacy Act Language

IC 228701 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⚠️ Notice: This information collection may be referencing outdated material.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 Cognitive Testing of Privacy Act Language	Form and Instructi
1 Privacy Act Test Language and FAQ Context Enclosure 1.docx	Form and Instruction
2 Confidentiality Statements in English Enclosure 2.docx	Form and Instruction
PA language testing OMB Memo.docx OMB Memo	IC Document
Enclosure 4.docx Consent Form	IC Document
Enclosure 3.docx Protocol	IC Document

IC Title:

Cognitive Testing of Privacy Act Language

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Privacy Act Test Language and FAQ Context	Enclosure 1.docx		No		Paper Only
Form and Instruction	2	Confidentiality Statements in English	Enclosure 2.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: 0 %

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	PA language testing OMB Memo.docx	10/18/2017
Consent Form	Enclosure 4.docx	10/18/2017
Protocol	Enclosure 3.docx	10/18/2017

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