Information Collection

Consumer Pilot Test Survey for the Converter Box Coupon Program

IC 183346 under ICR 200801-0660-001 · OMB 0660-0025.

Documents and Forms

Document Name Document Type
Consumer Pilot Test Survey for the Converter Box Coupon Program Form and Instruction
Consumer Pilot Test Survey 0660.ConsumerSurvey.CoupProg.PilotTest.01908.doc http:\\www.dtv.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Pilot Test Survey for the Converter Box Coupon Program	Agency IC Tracking Number:

Is this a Common Form? No		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	None	Consumer Pilot Test Survey	0660.ConsumerSurvey.CoupProg.PilotTest.01908.doc	http:\\www.dtv.gov	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Legislative Functions

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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