Information Collection

Various Demographic Area Pretesting Activities

IC 200762 under ICR 201006-0607-004 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
omb1127SASSenc1.docx	Other-Schools & Staffing Survey Pret
omb1127SASSenc2.doc	Other-Schools & Staffing Survey Pret
omb1127SASSenc3.doc	Other-Schools & Staffing Survey Pret
omb1127SASSenc4.docx	Other-Schools & Staffing Survey Pret
omb1127SASSenc5.doc	Other-Schools & Staffing Survey Pret
omb1127SASSenc6.doc	Other-Schools & Staffing Survey Pret
omb1127SASSenc7.doc	Other-Schools & Staffing Survey Pret
omb1127SASSenc8.doc	Other-Schools & Staffing Survey Pret
omb1128identitytheftsupplementenc.doc	Other-2012 NCVS Identity Theft Supp.
omb1130fsspomsenc1_rev2.doc	Other-FSS Public Opinion Monitoring
omb1130fsspomsenc2_rev2.doc	Other-FSS Public Opinion Monitoring
Consent forms for FSS Survey.doc	Other-FSS Public Opinion Monitoring
omb1134ACSInternetenc1.pptx	Other-ACS Internet Testing Enclosure
omb1134ACSinternetenc2rev.doc	Other-ACS Internet Testing Enclosure
omb1134ACSinternetenc3.doc	Other-ACS Internet Testing Enclosure
omb1134ACSInternetenc4rev.doc	Other-ACS Internet Testing Enclosure
omb1135healthinsuranceenc.doc	Other-Health Insurance Questions Tes
mod guide eng FG 3 and 4 FINAL.docx	Other-Health Insurance Questions Tes
mod guide questionnaire eng FG 3 and 4 FINAL.docx	Other-Health Insurance Questions Tes
recruitment plan FG 3 and 4 FINAL.docx	Other-Health Insurance Questions Tes
omb1136AFFenc1.doc	Other-AFF Usability Testing (Round 1
omb1136AFFenc2.doc	Other-AFF Usability Testing (Round 1
omb1136AFFenc3.docx	Other-AFF Usability Testing (Round 1
omb1136AFFenc4.doc.docx	Other-AFF Usability Testing (Round 1
omb1136AFFenc5.docx	Other-AFF Usability Testing (Round 1
Satisfaction Questionnaire_agile 2012.doc	Other-AFF Usability Testing (Round 1
omb1137fertilityenc.doc	Other-CPS Fertility Supp. Testing En
OMB1138AFFenc1.doc	Other-AFF Usability Testing (Round 2
OMB1138AFFenc2.doc	Other-AFF Usability Testing (Round 2
OMB1138AFFenc3.docx	Other-AFF Usability Testing (Round 2
OMB1138AFFenc4.docx	Other-AFF Usability Testing (Round 2
OMB1138AFFenc5.doc	Other-AFF Usability Testing (Round 2
OMB1138AFFenc6.docx	Other-AFF Usability Testing (Round 2
omb1139FSSPOSenc_rev1.doc	Other-FSS Trust Tracking Survey Pret
omb1140coveragetestingenc1.doc	Other-Testing of Residence Questions
omb1140coveragetestingenc2.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc3.doc	Other-Testing of Residence Questions
omb1140coveragetestingenc4.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc5.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc6.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc7.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc8.docx	Other-Testing of Residence Questions
omb1140coveragetestingenc9.docx	Other-Testing of Residence Questions
OMB1140coveragetestingenc10.docx	Other-Testing of Residence Questions
omb1127SASS.doc Schools & Staffing Survey Pretesting Plan	IC Document
omb1128identitytheftsupplement.doc 2012 NCVS Identity Theft Supp. Pretesting Plan	IC Document
omb1130fsspoms_rev.docx FSS Public Opinion Monitoring Survey Pretesting Plan	IC Document
omb1134ACSinternet.doc ACS Internet Testing Plan	IC Document
omb1135healthinsurance.doc Health Insurance Questions Testing Plan	IC Document
OMB1136AFF.doc AFF Usability Testing (Round 1) Plan	IC Document
omb1137fertility.doc CPS Fertility Supp. Testing Plan	IC Document
OMB1138AFF.doc AFF Usability Testing (Round 2) Plan	IC Document
omb1139fsspos-1rev1.doc FSS Trust Tracking Survey Pretesting Plan	IC Document
omb1140coveragetesting.doc Testing of Residence Questions Plan	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Various Demographic Area Pretesting Activities

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-FSS Public Opinion Monitoring Survey Pretesting Enclosure 1	omb1130fsspomsenc1_rev2.doc	No	Paper Only
Other-FSS Public Opinion Monitoring Survey Pretesting Enclosure 2	omb1130fsspomsenc2_rev2.doc	No	Paper Only
Other-FSS Public Opinion Monitoring Survey Pretesting Enclosure 3	Consent forms for FSS Survey.doc	No	Paper Only
Other-ACS Internet Testing Enclosure 1	omb1134ACSInternetenc1.pptx	No	Paper Only
Other-ACS Internet Testing Enclosure 2	omb1134ACSinternetenc2rev.doc	No	Paper Only
Other-ACS Internet Testing Enclosure 3	omb1134ACSinternetenc3.doc	No	Paper Only
Other-ACS Internet Testing Enclosure 4	omb1134ACSInternetenc4rev.doc	No	Paper Only
Other-Health Insurance Questions Testing Enclosure 1	omb1135healthinsuranceenc.doc	No	Paper Only
Other-Health Insurance Questions Testing Enclosure 2	mod guide eng FG 3 and 4 FINAL.docx	No	Paper Only
Other-Health Insurance Questions Testing Enclosure 3	mod guide questionnaire eng FG 3 and 4 FINAL.docx	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 1	omb1127SASSenc1.docx	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 2	omb1127SASSenc2.doc	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 3	omb1127SASSenc3.doc	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 4	omb1127SASSenc4.docx	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 5	omb1127SASSenc5.doc	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 6	omb1127SASSenc6.doc	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 7	omb1127SASSenc7.doc	No	Paper Only
Other-Schools & Staffing Survey Pretesting Enclosure 8	omb1127SASSenc8.doc	No	Paper Only
Other-2012 NCVS Identity Theft Supp. Pretesting Enclosure	omb1128identitytheftsupplementenc.doc	No	Paper Only
Other-Health Insurance Questions Testing Enclosure 4	recruitment plan FG 3 and 4 FINAL.docx	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 1	omb1136AFFenc1.doc	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 2	omb1136AFFenc2.doc	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 3	omb1136AFFenc3.docx	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 4	omb1136AFFenc4.doc.docx	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 5	omb1136AFFenc5.docx	No	Paper Only
Other-AFF Usability Testing (Round 1) Enclosure 6	Satisfaction Questionnaire_agile 2012.doc	No	Paper Only
Other-CPS Fertility Supp. Testing Enclosure	omb1137fertilityenc.doc	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 1	OMB1138AFFenc1.doc	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 2	OMB1138AFFenc2.doc	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 3	OMB1138AFFenc3.docx	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 4	OMB1138AFFenc4.docx	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 5	OMB1138AFFenc5.doc	No	Paper Only
Other-AFF Usability Testing (Round 2) Enclosure 6	OMB1138AFFenc6.docx	No	Paper Only
Other-FSS Trust Tracking Survey Pretesting Enclosure	omb1139FSSPOSenc_rev1.doc	No	Paper Only
Other-Testing of Residence Questions Enclosure 1	omb1140coveragetestingenc1.doc	No	Paper Only
Other-Testing of Residence Questions Enclosure 2	omb1140coveragetestingenc2.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 3	omb1140coveragetestingenc3.doc	No	Paper Only
Other-Testing of Residence Questions Enclosure 4	omb1140coveragetestingenc4.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 5	omb1140coveragetestingenc5.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 6	omb1140coveragetestingenc6.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 7	omb1140coveragetestingenc7.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 8	omb1140coveragetestingenc8.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 9	omb1140coveragetestingenc9.docx	No	Paper Only
Other-Testing of Residence Questions Enclosure 10	OMB1140coveragetestingenc10.docx	No	Paper Only

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: 2,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,500	2,500
Annual IC Time Burden (Hours)	972	972
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Schools & Staffing Survey Pretesting Plan	omb1127SASS.doc	01/13/2012
2012 NCVS Identity Theft Supp. Pretesting Plan	omb1128identitytheftsupplement.doc	01/13/2012
FSS Public Opinion Monitoring Survey Pretesting Plan	omb1130fsspoms_rev.docx	01/13/2012
ACS Internet Testing Plan	omb1134ACSinternet.doc	01/13/2012
Health Insurance Questions Testing Plan	omb1135healthinsurance.doc	01/13/2012
AFF Usability Testing (Round 1) Plan	OMB1136AFF.doc	01/13/2012
CPS Fertility Supp. Testing Plan	omb1137fertility.doc	01/13/2012
AFF Usability Testing (Round 2) Plan	OMB1138AFF.doc	01/13/2012
FSS Trust Tracking Survey Pretesting Plan	omb1139fsspos-1rev1.doc	01/13/2012
Testing of Residence Questions Plan	omb1140coveragetesting.doc	01/13/2012

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