System Usability Scale (SUS)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0179 can be found here:

Documents and Forms

Document Name Document Type
Form 1 System Usability Scale (SUS) Form and Instruction
1 System Usability Scale (SUS) Attachment H_System Usability Scale_101818.docx Form and Instruction
Fast Track Submission_System Usability Survey_101818.doc Fast Track Supporting Statement IC Document
Supporting Statement_101818.doc Total Overview IC Document
Cover Page SUB.doc Cover Letter IC Document

Information Collection (IC) Details

IC Title:	System Usability Scale (SUS)	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	1	System Usability Scale (SUS)	Attachment H_System Usability Scale_101818.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Supporting Statement	Fast Track Submission_System Usability Survey_101818.doc	10/29/2018
Total Overview	Supporting Statement_101818.doc	10/29/2018
Cover Letter	Cover Page SUB.doc	10/29/2018

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