CEDSCI Usability Addendum

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⚠️ Notice: This information collection may be referencing outdated material.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 CEDSCI Usability Addendum Form
1 Demographic Questionnaire CEDSCI enclosure3.docx Form
2 Internet Experience Questionnaire CEDSCI enclosure4.docx Form
3 Debriefing Questionnaire CEDSCI enclosure5.docx Form
4 Satisfaction Questionnaire CEDSCI enclosure6.docx Form
addendum to add in census refresh_4_25_18.docx OMB Memo IC Document
CEDSCI enclosure1.docx Study Plan IC Document
CEDSCI enclosure2.docx Protocol IC Document
OMB letter - CEDSCI usability testing_rev (1).docx Previously Approved OMB Memo IC Document

Information Collection (IC) Details

IC Title:	CEDSCI Usability Addendum	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	1	Demographic Questionnaire	CEDSCI enclosure3.docx	No	Fillable Fileable
Form	2	Internet Experience Questionnaire	CEDSCI enclosure4.docx	No	Fillable Fileable
Form	3	Debriefing Questionnaire	CEDSCI enclosure5.docx	No	Fillable Fileable
Form	4	Satisfaction Questionnaire	CEDSCI enclosure6.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: 28	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	28	28
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	addendum to add in census refresh_4_25_18.docx	04/27/2018
Study Plan	CEDSCI enclosure1.docx	03/07/2018
Protocol	CEDSCI enclosure2.docx	03/07/2018
Previously Approved OMB Memo	OMB letter - CEDSCI usability testing_rev (1).docx	04/27/2018

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