Information Collection

Website Usability Testing Customer Feedback. DVP

IC 228213 under ICR 201612-0920-007 · OMB 0920-1009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920- 17AV Website Usability Testing Customer Feedback. DVP	Form and Instruction
0920- 17AV Attachment 2 Survey Attachment 2 Survey.docx	Form and Instruction
0920-1009 17BAV Attachment 3. Survey Screen Shots Attachment 3. Survey Screen Shots.docx	Form and Instruction
GenIC Request_DVP Webpages Usability Testing _090717Clean.docx GenIC Request_DVP Webpages Usability Testing _090717Clean	IC Document

IC Title:

Agency IC Tracking Number:

0920-17BAV

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	0920- 17AV	Attachment 2 Survey	Attachment 2 Survey.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-1009 17BAV	Attachment 3. Survey Screen Shots	Attachment 3. Survey Screen Shots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request_DVP Webpages Usability Testing _090717Clean	GenIC Request_DVP Webpages Usability Testing _090717Clean.docx	09/07/2017

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