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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
2017 ABS Usability Testing
New
20
25
0
Form
1
Instrument screenshots
2017 American Community Survey Respondent Burden Testing
New
48
46
0
Form
Paper Survey Questions
Paper Survey Questions
Form
Interviewer-Administered Survey Questions
Interviewer-Administered Survey Questions
Form
Interviewer-Administered Roster Questions
Interviewer-Administered Roster Questions
2017 Annual Survey of Businesses Cog Testing
New
20
25
0
Form and Instruction
1
Annual Survey of Businesses Questionnaire
2017 Economic Census Debriefings
New
100
75
0
Form and Instruction
1
Econ Census Web Screens
2017 Economic Census New Question Testing Addendum
New
30
28
0
Form and Instruction
Petroleum Construction Natural Gas Questions
Petroleum Construction Natural Gas Questions
2017 Economic Census Usability Testing and Debriefs
New
75
94
0
Form
1
Demographics Questionnaire
Form
2
Computer Use and Internet Experience Questionnaire
Form
3
Satisfaction Questionnaire
2017 FNS Usability Testing
New
58
61
0
Form and Instruction
1
Application
2017 NCVS Mail Materials Project
New
15
18
0
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
2017 PRA Testing
New
25
31
0
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
2017 SAS Cognitive Interviews
New
50
63
0
Form
1
Draft Questions
2018 ABS Technology Module Cog Testing
New
20
25
0
Form and Instruction
1
ABS Questionnaire
Form and Instruction
2
ABS R and D Questionnaire
Form and Instruction
3
Attachment D - Technology Module Questionnaire
2018 ACS Respondent Burden Testing
New
24
40
0
Form and Instruction
1
ACS Questionnaire Up to Q28
Form and Instruction
2
ACS Questionnaire From Q29 V1
Form and Instruction
3
ACS Questionnaire From Q29 V2
2018 BRDIS Cognitive Testing
New
40
50
0
Form and Instruction
1
BRDIS 2016
Form and Instruction
2
Geography Questions
Form and Instruction
3
Capitol Stock Questions
Form and Instruction
4
Consent Form
2018 Census Test GQE eResponse Debriefings
New
20
83
0
Form and Instruction
1
2018 GQE eResponse Site
Form and Instruction
2
eResponse Reporting Template
Form and Instruction
3
Invitation Letter
Form and Instruction
4
eResponse User Manual
2018 Centurion Site Tutorial Videos Cog Testing
New
30
38
0
Form
1
Video Screenshots
Form
2
Usability Tasks
Form and Instruction
3
Video Satisfaction Questionnare
2018 MOPS Hospitals
New
40
67
0
Form and Instruction
1
Questionnaire
2018 NCVS PPCS Cognitive Interviews
New
50
88
0
Form
1
Full Questionnaire
2018 NSCH Usability Evaluation
New
18
34
0
Form and Instruction
1
Questionnaire V1
Form and Instruction
2
Questionnaire V2
Form and Instruction
3
Questionnaire V3
Form and Instruction
4
Questionnaire V4
Form and Instruction
5
Demographic Questionnaire
Form and Instruction
6
Satisfaction Questionnaire
2019 ABS Globalization Module Cognitive Testing
New
40
50
0
Form and Instruction
1
Globalization Module draft
2019 ABS Innovation Module Cognitive Testing
New
40
50
0
Form and Instruction
1
Revised Innovation Module
Form and Instruction
2
Innovation Handout
Form and Instruction
3
Barriers and Drivers Handout
Form and Instruction
4
Business Strategies Handout
Form and Instruction
5
Digital Tech Cards
Form and Instruction
6
Tech Capabilities List
2019 ACS POW-HOA Cognitive Testing to Reduce Burden
New
12
21
0
Form and Instruction
1
Modified ACS Paper Form
2019 AHS Cognitive Testing
New
35
53
0
Form and Instruction
1
Protocol and Questionnaire
2019 AHS Housing Insecurity Cognitive Testing
New
15
23
0
Form and Instruction
1
Protocol and Questionnaire
2019 Generic Screener with UYC Pilot Screener
New
1500
125
0
Form
1
Screeners part A and part B
2019 SAS Telemedicine Cog Interviews
New
50
35
0
Form
1
Attachment A - Proposed Telemedicine Questions for SAS
Form
2
Attachment C - SAS Questionnaire
2020 CBAMS Addendum
New
1
1
0
Form and Instruction
1
Demographic Questionnaire
Form and Instruction
2
Internet and Mobile Experience Questionnaire
2020 CPEX Extending the Census Environment Cog Testing
New
25
25
0
Form and Instruction
1
Mailing Materials
2020 Census Vacant Unit Crowdsourcing Research
New
500
84
0
Form and Instruction
1
Online Instrument
2020 Privacy & Confidentiality Cognitive Testing
New
300
83
0
Form and Instruction
1
2020 Census Draft w/ citizenship
Form and Instruction
2
2020 Census Draft w/o citizenship
Form and Instruction
3
2020 Census Follow Up Survey w/ citizenship
Form and Instruction
4
2020 Census Follow Up Survey w/o citizenship
Form and Instruction
5
Online Questionnaire w/ citizenship
Form and Instruction
6
Online Questionnaire w/o citizenship
2020 Respondent Privacy Cognitive Interviews
New
40
44
0
Form and Instruction
1
Privacy Concerns Questionnaire
2020 Respondent Privacy Cognitive Interviews Round 2
New
20
22
0
Form and Instruction
1
Privacy and Confidentiality Questionnaire
2020 Tracking Survey
New
905
191
0
Form and Instruction
1
Cog Testing - Census Tracking Questionnaire
Form and Instruction
2
Cog Testing - Web Form of Census Tracking Questionnaire
Form and Instruction
3
Cog Testing - Demographics Questionnaire
Form and Instruction
4
Web Probe Testing - Language Questions for Web
Form and Instruction
5
Web Probe Testing - Screencap of Introduction to Web Survey
Form and Instruction
6
Web Probe Testing - Screencaps of Web Testing
ABS Telephone Respondent Debriefings
New
30
23
0
Form and Instruction
1
2017 ABS Questionnaire
ACES Machine Learning Debriefings
New
30
23
0
Form and Instruction
1
Screenshots of Instrument
ACES Robotics
New
40
81
0
Form and Instruction
1
Question
ACS Respondent Burden Cognitive Testing
New
24
58
0
Form and Instruction
1
Survey Questions
Form and Instruction
2
Roster Questions for Group 1
Form and Instruction
3
Roster Questions for Group 2
ACS Respondent Comment/Feedback Addendum
New
15
7
0
Form and Instruction
1
Entire ACS Questionnaire
Form and Instruction
2
ACS Respondent Feedback items at end of ACS Questionnaire
ACS Respondent Perceptions of Burden
New
96
102
0
Form and Instruction
1
Paper Survey
Form
2
Follow Up Questions
ASM Robotics
New
40
81
0
Form and Instruction
1
Version A Questions
Form and Instruction
2
Version B Questions
Form and Instruction
3
Version C Questions
Form and Instruction
4
Version D Questions
ASM Robotics Debriefings
New
20
15
0
Form and Instruction
1
Robotics Questions
ASPP Cognitive Interviews
New
20
25
0
Form
1
Questionnaire
Addendum for IOE Mobile UI Project Phase 2
New
180
195
0
Form and Instruction
1
Test materials as seen by respondents
American Community Survey (ACS) Respondent Comment/Feedback
New
35
21
0
Instruction
Form
2017 ACS form
2017 ACS form
Form
Comment and Feedback Question
Comment and Feedback Question
Annual Retail Trade Survey Cognitive Testing
New
35
26
0
Form and Instruction
1
Select Survey Items
BE-120 Cognitive Interviews
New
45
93
0
Form and Instruction
BE-120
Questionnaire
Form and Instruction
BE-120 V1
Version 1 Supplement
Form and Instruction
BE-120 V2
Version 2 Supplement
BE-125 Respondent Debriefings
New
15
29
0
Form and Instruction
1
Questionnaire
BRDI-M Respondent Debriefings
New
25
31
0
Form and Instruction
1
Protocol
BRDS Cognitive Testing
New
20
30
0
Form and Instruction
1
Aritificial Intelligence Questionnaire
Form and Instruction
2
Leased / Temporary Employees Questionnaire
Business Unit Harmonization Phase 3
New
20
82
0
Form and Instruction
1
BUH MockUp
Business Unit Harmonization Project Case Studies
New
5
6
0
Form
1
Protocol
Business Unit Harmonization Project Case Studies Addendum
New
10
30
0
Form
1
Protocol
CBAMS Cognitive and Usability Interviews
New
40
60
0
Form and Instruction
1
Paper Questionnaire
Form and Instruction
2
Demographics Questionnaire
Form and Instruction
3
Usability Satisfaction Questionnaire
CEDSCI Usability Addendum
New
28
28
0
Form
1
Demographic Questionnaire
Form
2
Internet Experience Questionnaire
Form
3
Debriefing Questionnaire
Form
4
Satisfaction Questionnaire
CEDSCI Usability Evaluation
New
168
252
0
Form
Demographic Information
Demographic Information
Form
Internet and Smartphone Experience Questions
Internet and Smartphone Experience Questions
Form
Debriefing Question
Debriefing Question
CEDSCI Usability Evaluation Addendum
New
63
63
0
Form
1
Demographics Questionnaire
Form
2
Internet Use Questionnaire
Form
3
Debriefing Questionnaire
Form
4
Satisfaction Questionnaire
CFS Debriefing Study
New
40
50
0
Form and Instruction
1
Questionnaire
CPS Food Security Supplement
New
30
50
0
Form and Instruction
1
Protocol and Questionnaire
Census Test Usability Testing Addendum
New
216
384
0
Instruction
Form and Instruction
1
Instrument Debriefing Screens
Form and Instruction
2
Demographics Questionnaire
Form and Instruction
3
Mobile Experience Questionnaire
Form and Instruction
4
Satisfaction Questionnaire
Cognitive Testing of Privacy Act Language
New
40
60
0
Form and Instruction
1
Privacy Act Test Language and FAQ Context
Form and Instruction
2
Confidentiality Statements in English
Current Population Survey Computer and Internet Use (CPS CIU) Supplemental Test
New
50
50
0
Form
CPS CIU Roster Questionnaire
CPS CIU Roster Questionnaire
Form
CPS CIU Full Questionnaire
CPS CIU Full Questionnaire
Early Stage Scoping for the Commodity Flow Survey
New
40
50
0
Form and Instruction
1
2017 CFS Instrument
Econ Record Keep Study
New
30
128
0
Form and Instruction
1
Example Chart
Form and Instruction
2
Example Survey Questions
FGP Econ Census Respondent Debriefings
New
40
30
0
Form
1
FGP Questions from Econ Census
MEPS Cognitive Testing
New
60
35
0
Form and Instruction
1
Form MEPS 10
Form and Instruction
2
Form MEPS 10s
Form and Instruction
3
Form MEPS 11
Form and Instruction
4
Form MEPS 11s
MEPS Telephone Interviews
New
100
58
0
Form and Instruction
1
2018 MEPS-10 Form
Form and Instruction
2
2018 MEPS-10S Form
Form and Instruction
3
2017 MEPS-10 Form
Form and Instruction
4
2017 MEPS-10S Form
MEPS–IC Cog Testing
New
50
29
0
Form and Instruction
1
MEPS-10
Form and Instruction
2
MEPS-10S
Form and Instruction
3
MEPS-11
Form and Instruction
4
MEPS-11S
Mobile UI Design Framework for Survey Operations – Phase 1, Study 2
New
180
0
0
Form and Instruction
1
Experimental Info
Form and Instruction
2
Privacy Act Statement
NAPCS Debriefings
New
100
75
0
Form and Instruction
1
NAPCS Instrument Screens
NAPCS Questionnaire Field Test
New
872
2636
0
Form and Instruction
1
Questionnaire
Form and Instruction
2
Debriefing
NSCH Mail Materials Cognitive Testing
New
30
36
0
Form and Instruction
1
Mail Materials
NSCH Questionnaire Cognitive Interviews
New
54
65
0
Form and Instruction
1
Screener Survey
Form and Instruction
2
Cognitive Interview Version 1
Form and Instruction
3
Cognitive Interview Version 2
Form and Instruction
4
Cognitive Interview Version 3
NSCH Questionnaire Cognitive Testing
New
30
36
0
Form and Instruction
1
English Screener
Form and Instruction
2
English Topical Questionnaire 1
Form and Instruction
3
English Topical Questionnaire 2
Form and Instruction
4
English Topical Questionnaire 3
Form and Instruction
5
Spanish Screener
Form and Instruction
6
Spanish Topical Questionnaire 1
Form and Instruction
7
Spanish Topical Questionnaire 2
Form and Instruction
8
Spanish Topical Questionnaire 3
NSCH Screener Cognitive Interviews
New
30
36
0
Form and Instruction
1
Screener Card
Form and Instruction
2
Experimental Treatment B - NonPerforated Mockup 1
Form and Instruction
3
Experimental Treatment B - NonPerforated Mockup 2
Form and Instruction
4
Experimental Treatment B - Perforated Mockup 1
Form and Instruction
5
Experimental Treatment B - Perforated Mockup 2
Form and Instruction
6
Experimental Treatment C
Form and Instruction
7
Standard Treatments A and D
Form and Instruction
8
NonPerforated Mockup 1
Form and Instruction
9
NonPerforated Mockup 2
Form and Instruction
10
Perforated Mockup 1
Form and Instruction
11
Perforated Mockup 2
NSP Usability Testing
New
10
18
0
Form and Instruction
1
Log On Letter
Form and Instruction
2
Paper Questionnaire
Form and Instruction
3
Demographic Questionnaire
Form and Instruction
4
Mobile Experience Questionnaire
Form and Instruction
5
Satisfaction Questionnaire
NSSRN Cognitive Testing
New
15
26
0
Form and Instruction
Questionnaire
Questionnaire
Form
Screener
Screener
NSSRN Usability Evaluation
New
16
27
0
Form and Instruction
1
Demographics Questionnaire
Form and Instruction
2
Debriefing Questions
Form and Instruction
3
Satisfaction Questionnaire
Form and Instruction
4
NSSRN Questionnaire
NYCHVS Cognitive Interviews
New
72
108
0
Form and Instruction
1
Protocol V1 (Owner)
Form and Instruction
2
Protocol V2 (Renter)
Form and Instruction
3
Flash Cards
National Survey of Psychiatrists Cognitive Testing
New
30
36
0
Form and Instruction
1
Questionnaire
Form and Instruction
2
Alternative Full page Coversheet w/ Questionnaire (beginning)
Form and Instruction
3
Alternative Cover Image 1
Form and Instruction
4
Alternative Cover Image 2
Pretest Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)
New
50
29
0
Form and Instruction
MEPS – IC
Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)
Quarterly Survey of Public Pensions Cognitive Testing
New
15
19
0
Form and Instruction
1
QSPP Draft Questionnaire
Recruitment Screener
New
4000
333
0
Form and Instruction
Telephone Recruitment Screener
Telephone Recruitment Screener
Form and Instruction
Internet Screener
Internet Screener
SAS E-Commerce Respondent Debriefings
New
30
38
0
Form
1
E-Commerce Questions
UYC Cog Testing and Focus Groups
New
210
480
0
Form and Instruction
1
Focus Group Protocol
Form and Instruction
2
Cognitive Interviewing Protocol
Vacant Crowdsourcing Internet Study
New
30
33
0
Form and Instruction
1
Mailing Materials
Form and Instruction
2
Version 1 of Address Display
Form and Instruction
3
Version 2 of Address Display
Form and Instruction
4
Version 3 of Address Display
Form and Instruction
5
Version 4 of Address Display
Form and Instruction
6
Version 5 of Address Display
Form and Instruction
7
Version 6 of Address Display
Form and Instruction
8
Satisfaction with Instrument Questionnaire
Form and Instruction
9
Preference of Address Display Question
Web Satisfaction Questionnaire Development
New
120
20
0
Form and Instruction
Web Satisfaction Questionnaire
Web Satisfaction Questionnaire
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
11760
8034
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
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