Bullet Black Box Participant Background Survey

NIST Generic Clearance for Program Evaluation Data Collections

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0033 can be found here:

Documents and Forms

Document Name Document Type
0693-0033_BulletBB Participant Background Questionnaire SCREENSHOTS_.pdf Other-Survey
0693-0033_BulletBB Participant Background Questionnaire_WordDoc.docx Word version of survey IC Document
0693-0033_BulletBB_SuppStatement.final.doc Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Bullet Black Box Participant Background Survey	Agency IC Tracking Number:	ER

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			0693-0033_BulletBB Participant Background Questionnaire SCREENSHOTS_.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Word version of survey	0693-0033_BulletBB Participant Background Questionnaire_WordDoc.docx	04/24/2019
Supporting Statement	0693-0033_BulletBB_SuppStatement.final.doc	04/29/2019

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