Information Collection

QR Code usability testing for mobile surveys

IC 251261 under ICR 202006-0690-002 · OMB 0690-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1. Recruitment Flyer - Census.pdf	Other-Enclosure 1
2. Screener Questions - Census.docx	Other-Enclosure 2
3. Informed Consent - Census.docx	Other-Enclosure 3
4. Protocol - Census.docx	Other-Enclosure 4
5. Demographic Questionnaire - Census.docx	Other-Enclosure 5
6. PC Task - Census.docx	Other-Enclosure 6
7. Smartphone Task - Census.docx	Other-Enclosure 7
8. Satisfaction Questionnaire - Census.docx	Other-Enclosure 8
9. Debriefing Questions - Census.docx	Other-Enclosure 9
10. Incentive Form - Census.docx	Other-Enclosure 10
OMB letter QR Code - Census.docx OMB letter QR Code – Census	IC Document
Fast Track Generic Clearance Request for the Collection of Routine Customer Feedback - Census.docx Fast Track Generic Clearance Request - Census	IC Document

IC Title:

QR Code usability testing for mobile surveys

Agency IC Tracking Number:

Census

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Enclosure 1	Yes	Yes	Fillable Fileable
Other-Enclosure 2	Yes	Yes	Fillable Fileable
Other-Enclosure 3	Yes	Yes	Fillable Fileable
Other-Enclosure 4	Yes	Yes	Fillable Fileable
Other-Enclosure 5	Yes	Yes	Fillable Fileable
Other-Enclosure 6	Yes	Yes	Fillable Fileable
Other-Enclosure 7	Yes	Yes	Fillable Fileable
Other-Enclosure 8	Yes	Yes	Fillable Fileable
Other-Enclosure 9	Yes	Yes	Fillable Fileable
Other-Enclosure 10	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	60	60
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB letter QR Code â Census		01/25/2022
Fast Track Generic Clearance Request - Census		01/25/2022

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

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