Information Collection

Web Diary Feasibility Test CE Diary

IC 202923 under ICR 201211-1220-001 · OMB 1220-0050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0050 can be found here:

Documents and Forms

Document Name Document Type
Form Web Diary Requirem Web Diary Feasibility Test CE Diary Form and Instruction
Web Diary Requirem Web Diary Requirements Attachment D - Diary 2012 instrument requirements - Web Diary Test changes revised 2012-10.docx Form and Instruction
Web Diary Screen S Web Diary Screen Shots Attachment E - Screen shots Web Diary 10-9-12.docx Form and Instruction
Web Diary Screenin Web Diary Screening and Debriefing Questions Attachment F - Web Diary - Screening and Debriefing Questions.docx Form and Instruction
Attachment C - WDF_study_overview 10.9.12.doc Web Diary Feasibility Study Overview IC Document
Attachment G - Sampling plan.docx Attachment G - Sampling Plan IC Document
Attachment H - Web Diary Usability Round 1 (Final - 5.17.2012).docx Attachment H - Web Diary Usability Round 1 IC Document
Attachment I - Web Diary Usability Round 2 (Final).docx Attachment I - Web Diary Usability Round 2 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Web Diary Feasibility Test CE Diary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Web Diary Requirements	Web Diary Requirements	Attachment D - Diary 2012 instrument requirements - Web Diary Test changes revised 2012-10.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Web Diary Screen Shots	Web Diary Screen Shots	Attachment E - Screen shots Web Diary 10-9-12.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Web Diary Screening and Debriefing Questions	Web Diary Screening and Debriefing Questions	Attachment F - Web Diary - Screening and Debriefing Questions.docx	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: 500	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	Previously Approved
Annual Number of Responses for this IC	1,750	322	1,428
Annual IC Time Burden (Hours)	535	0	535
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Web Diary Feasibility Study Overview	Attachment C - WDF_study_overview 10.9.12.doc	10/10/2012
Attachment G - Sampling Plan	Attachment G - Sampling plan.docx	08/15/2012
Attachment H - Web Diary Usability Round 1	Attachment H - Web Diary Usability Round 1 (Final - 5.17.2012).docx	08/15/2012
Attachment I - Web Diary Usability Round 2	Attachment I - Web Diary Usability Round 2 (Final).docx	10/10/2012

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