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Cognitive Testing
Research to support the National Crime Victimization Survey (NCVS)
OMB: 1121-0325
IC ID: 198392
OMB.report
DOJ/OJP
OMB 1121-0325
ICR 200904-1121-002
IC 198392
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:
2015-10-27 - Reinstatement without change of a previously approved collection
2012-05-08 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
DOJ survey 2B_r1.pdf
Other-Form: Mail Screener
DOJ survey 2C_r1.pdf
Other-Form: Mail Screener
NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx
Other-Interview Protocol
NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx
Other-Interview Protocol
Appendix B Informed Consent Form.pdf
Informed Consent Form
IC Document
Appendix C Recruiting Advertisement Material.pdf
Recruiting Advertisement Material
IC Document
Appendix D Recruiting Script and Screener.pdf
Recruiting Script and Screener
IC Document
Appendix E Crime Scenarios for 2c Screener Testing.pdf
Crime Scenarios for 2C Screener Testing
IC Document
NCVS-CS - Project Summary.docx
NCVS CS Project Summary
IC Document
OMB_covermemo_cogs_Response_7 20.docx
Qs and As between BJS and OMb
IC Document
OMB MEMO for NCVS Cognitive Testing Revised.pdf
Justification memo to OMB
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cognitive Testing
Agency IC Tracking Number:
BJS
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
Other-Form: Mail Screener
DOJ survey 2C_r1.pdf
No
Paper Only
Other-Form: Mail Screener
DOJ survey 2B_r1.pdf
No
Paper Only
Other-Interview Protocol
NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx
No
Paper Only
Other-Interview Protocol
NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Science and Innovation
Subfunction:
Scientific and Technological Research and Innovation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
150
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
150
0
150
0
0
0
Annual IC Time Burden (Hours)
79
0
79
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Informed Consent Form
Appendix B Informed Consent Form.pdf
07/05/2011
Recruiting Advertisement Material
Appendix C Recruiting Advertisement Material.pdf
07/05/2011
Recruiting Script and Screener
Appendix D Recruiting Script and Screener.pdf
07/05/2011
Crime Scenarios for 2C Screener Testing
Appendix E Crime Scenarios for 2c Screener Testing.pdf
07/05/2011
NCVS CS Project Summary
NCVS-CS - Project Summary.docx
07/05/2011
Qs and As between BJS and OMb
OMB_covermemo_cogs_Response_7 20.docx
07/27/2011
Justification memo to OMB
OMB MEMO for NCVS Cognitive Testing Revised.pdf
07/27/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.