Information Collection

User Testing (Deep Dive)

IC 266242 under ICR 202403-0990-006 · OMB 0990-0491.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0491 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx	Other-template
Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx	Other-template
Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx	Other-
Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx	Other-

IC Title:

User Testing (Deep Dive)

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-template			Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx		Yes	Yes	Fillable Fileable
Other-			Generic ICR Template_A11 Section 280 Clearance 12 4 23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	200	200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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