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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
2020 Privacy & Confidentiality Cognitive Testing
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
2020 Census Draft w/ citizenship
Enclosure 3 - Draft 2020 Census Quex.pdf
No
Fillable Fileable
Form and Instruction
2
2020 Census Draft w/o citizenship
Enclosure 3a - Draft 2020 Census Quex_revised.pdf
No
Fillable Fileable
Form and Instruction
3
2020 Census Follow Up Survey w/ citizenship
Enclosure 4 - Privacy and confidentiality questionnaire.docx
No
Fillable Fileable
Form and Instruction
4
2020 Census Follow Up Survey w/o citizenship
Enclosure 4a - Privacy and confidentiality questionnaire_revised20190722.docx
No
Fillable Fileable
Form and Instruction
5
Online Questionnaire w/ citizenship
Enclosure 6 - Example online testing protocol.docx
No
Fillable Fileable
Form and Instruction
6
Online Questionnaire w/o citizenship
Enclosure 6a - Example online testing protocol_revised.docx
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
300
0
300
0
0
0
Annual IC Time Burden (Hours)
83
0
83
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
OMB Cover Memo.docx
07/08/2019
Additional Screener Questions
Enclosure 1 - Additional screening questions.docx
07/08/2019
Recruitment Ads
Enclosure 2 - Recruitment materials.docx
07/08/2019
Cognitive Protocol
Enclosure 5 - Cognitive interview protocol.docx
07/08/2019
Consent Form
Enclosure 7 - Consent form.docx
07/08/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
An official website of the United States government
The .gov means it's official.
The site is secure.
