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  
To view an IC, click on IC Title