Cognitive Testing for the Survey of Respirator Use and Practices

Cognitive and Psychological Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Document Name Document Type
Form Attachments 1-3 Cognitive Testing for the Survey of Respirator Use and Practices Form and Instruction
Attachments 1-3 Survey Protocol - SRUP Phase 2 Cognitive Testing Attachments 1- 3 Survey Protocol - Final.docx Form and Instruction
Note to Reviewer - Survey of Respirator Use - Round 2 Cognitive Interviews May_21_Final.docx Note to Reviewer - Cognitive Testing for the Survey of Respirator Use and Practices IC Document

Information Collection (IC) Details

IC Title:	Cognitive Testing for the Survey of Respirator Use and Practices	Agency IC Tracking Number:

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 and Instruction	Attachments 1-3	Survey Protocol - SRUP Phase 2 Cognitive Testing	Attachments 1- 3 Survey Protocol - Final.docx		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Note to Reviewer - Cognitive Testing for the Survey of Respirator Use and Practices	Note to Reviewer - Survey of Respirator Use - Round 2 Cognitive Interviews May_21_Final.docx	07/07/2021

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