NCIPC Website Usability Testing

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Document Name Document Type
NCIPC Website Usability Testing Form
Usability Testing Instrument Attachment B. Usability Testing Instrument.docx Form
Screenshots Attachment C Screenshots.docx Form
Attachment A. Privacy Applicability.pdf Privacy applicability IC Document
1050 Request Template Service Delivery NCIPC Usability.docx Request for Approval IC Document

Information Collection (IC) Details

IC Title:	NCIPC Website Usability Testing	Agency IC Tracking Number:	0920-1050-20SG

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
Form	none	Usability Testing Instrument	Attachment B. Usability Testing Instrument.docx		Yes	Yes	Fillable Fileable
Form	none	Screenshots	Attachment C Screenshots.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Privacy applicability	Attachment A. Privacy Applicability.pdf	09/29/2020
Request for Approval	1050 Request Template Service Delivery NCIPC Usability.docx	09/29/2020

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