Information Collection

MyPBA Usability Study 2021

IC 247818 under ICR 202008-1212-007 · OMB 1212-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1212-0066 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
My PBA Usability Study Screener.docx My PBA Usability Study Screener	IC Document
MyPBA Usability Script - Not Yet Receiving Benefits.docx MyPBA Usability Script - Not Yet Receiving Benefits	IC Document
MyPBA Usability Script - Not Yet Receiving Benefits.docx MyPBA Usability Script - Not Yet Receiving Benefits	IC Document
MyPBA Usability Script - Receiving Benefits.docx MyPBA Usability Script - Receiving Benefits	IC Document
MyPBA Usability Script - Receiving Benefits.docx MyPBA Usability Script - Receiving Benefits	IC Document
MyPBA Usability Study Email Messages.docx MyPBA Usability Study Email Messages	IC Document
MyPBA Usability Study Email Messages.docx MyPBA Usability Study Email Messages	IC Document
Template for Generic Clearance Submission for Survey 2021.02.docx Supporting Statement	IC Document
Template for Generic Clearance Submission for Survey 2021.02.docx Supporting Statement	IC Document

IC Title:

MyPBA Usability Study 2021

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 4022

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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: PBGC â 6: Plan Participant and Beneficiary Data

FR Citation: 29 FR 4022

Number of Respondents: 15

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	15	15
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
My PBA Usability Study Screener	My PBA Usability Study Screener.docx	06/08/2021
MyPBA Usability Script - Not Yet Receiving Benefits	MyPBA Usability Script - Not Yet Receiving Benefits.docx	06/08/2021
MyPBA Usability Script - Not Yet Receiving Benefits	MyPBA Usability Script - Not Yet Receiving Benefits.docx	06/08/2021
MyPBA Usability Script - Receiving Benefits	MyPBA Usability Script - Receiving Benefits.docx	06/08/2021
MyPBA Usability Script - Receiving Benefits	MyPBA Usability Script - Receiving Benefits.docx	06/08/2021
MyPBA Usability Study Email Messages	MyPBA Usability Study Email Messages.docx	06/08/2021
MyPBA Usability Study Email Messages	MyPBA Usability Study Email Messages.docx	06/08/2021
Supporting Statement	Template for Generic Clearance Submission for Survey 2021.02.docx	06/08/2021
Supporting Statement	Template for Generic Clearance Submission for Survey 2021.02.docx	06/08/2021

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