Information Collection

G292: NextGen Initiatives 2018 Usability Testing

IC 232712 under ICR 201808-0651-001 · OMB 0651-0080.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0651-0080 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G292-1 G292: NextGen Initiatives 2018 Usability Testing	Form
G292-1 Facilitator Guide G292 Facilitator Guide - Usability Testing.docx	Form
G292-2 System Usability Scale G292 UX System Usability Scale.docx	Form
G292-3 Participant Feedback G292 UX Participant Feedback.docx	Form
G292-4 Participant Scenario Worksheet G292 UX Form - Participant Scenario Worksheet.docx	Form
Form - Background Information Apr 16.docx Form- Background Information	IC Document
Form - Audio-Video Consent Apr 16.docx Audio and Video Consent Form	IC Document
G292 NextGen Initiatives 2018 UX Submission Request.docx G292: NextGen Initiatives 2018 UX Submission Request	IC Document

IC Title:

G292: NextGen Initiatives 2018 Usability Testing

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G292-1	Facilitator Guide	G292 Facilitator Guide - Usability Testing.docx	Yes	Yes	Fillable Fileable
Form	G292-3	Participant Feedback	G292 UX Participant Feedback.docx	Yes	Yes	Fillable Fileable
Form	G292-4	Participant Scenario Worksheet	G292 UX Form - Participant Scenario Worksheet.docx	Yes	Yes	Fillable Fileable
Form	G292-2	System Usability Scale	G292 UX System Usability Scale.docx	Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records

Title: PAT/TM-19: Dissemination Events and Registrations

FR Citation: 71 FR 77739

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Form- Background Information	Form - Background Information Apr 16.docx	08/17/2018
Audio and Video Consent Form	Form - Audio-Video Consent Apr 16.docx	08/17/2018
G292: NextGen Initiatives 2018 UX Submission Request	G292 NextGen Initiatives 2018 UX Submission Request.docx	08/17/2018

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