Information Collection

201 Census Alternative Questionnaire Experiment

IC 188914 under ICR 201007-0607-003 · OMB 0607-0952.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0952 can be found here:

2011-03-25 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form D-1 X6 201 Census Alternative Questionnaire Experiment	Form
D-5(L) MOMB Advance Letter D5 12-12-08.pdf	Other-Standard 2010 Advance Letter
D-5 Advance letter Env D4 03-30-09.pdf	Other-Standard 2010 Advance Letter E
D-6A(IN) Initial MOMB Outgoing Env Draft 5 03-24-09.pdf	Other-Standard 2010 IQ Outgoing Enve
D-6B(AZ) MOMB Bilingual Outgoing Env Draft 3 03-24-09.pdf	Other-Standard 2010 IQ Outgoing Flat
D-8A(X1) Return Envelope for CPEX D2 040309.pdf	Other-2010 CPEX IQ Return Envelope (
D-8B Update Leave Bilingual & CPEX Return Env Draft 3 03302009.pdf	Other-2010 Experimental IQ Return En
D-16(L) MOMB Cover Letter D9 121208.pdf	Other-Standard 2010 IQ Cover Letter
D-16(L)(X1) CPEX Cover Letter D1_031809.pdf	Other-2010 Experimental IQ Cover Let
D-9 MOMB Reminder Postcard D6 121608.pdf	Other-Standard 2010 Reminder Postcar
D-6C(IN) Replacement Mail Outgoing Env Draft 4 03-24-09.pdf	Other-Standard 2010 RQ Outgoing Enve
D-6B(X13) Outgoing RM for CPEX D1 040909.pdf	Other-RQ Outgoing Flat Envelope (ope
D-8C(IN) UL and Repl Return Env Draft 7 040309.pdf	Other-2010 CPEX RQ Return Envelope (
D-17(L) MOMB Replacement Cover Ltr D9 121208.pdf	Other-Standard 2010 RQ Cover Letter
D-17(L)(X1) CPEX Replacement Mailing Letter D1 03252009.pdf	Other-2010 Experimental RQ Cover Let
D-1 XA Control A: Standard 2010 Questionnaire (including help l D-1(XA)_1_3_040209.pdf	Form
D-1 XB Control B: Standard 2010 Questionnaire without the overc D-1(XB)_1_3_040209.pdf	Form
D-1 X1 2010 Experimental Questionnaire Version 1 (Census 2000 f D-1(X1)_1_3_040809.pdf	Form
D-1 X2 2010 Experimental Questionnaire Version 2 (Combined Race D-1(X2)_1_3_D2_031309.pdf	Form
D-1 X3 2010 Experimental Questionnaire Version 3 (Combined Race D-1(X3)_1_2_022409.pdf	Form
D-1 X4 2010 Experimental Questionnaire Version 4 (Combined Race D-1(X4)_1_3_022509.pdf	Form
D-1 X5 2010 Experimental Questionnaire Version 5 (Combined Race D-1(X5)_1_2_022709.pdf	Form
D-1 X6 2010 Experimental Questionnaire Version 6 (Race) D-1(X6)_1_4_D3_030409.pdf	Form
D-1 X7 2010 Experimental Questionnaire Version 7 (Hispanic Orig D-1(X7)_1_5_022509.pdf	Form
D-1 X8 2010 Experimental Questionnaire Version 8 (Hispanic Orig D-1(X8)_1_6_D5_041509.pdf	Form
D-1 X9 2010 Experimental Questionnaire Version 9 (Race and Hisp D-1(X9)_1_2_D1_030409.pdf	Form
D-1 X10 2010 Experimental Questionnaire Version 10 (Race and His D-1(X10)_1_3_030409.pdf	Form
D-1 X11 2010 Experimental Questionnaire Version 11 (Race and His D-1(X11)_1_4_030609.pdf	Form
D-1 X12 2010 Experimental Questionnaire Version 12 (Hispanic Ori D-1(X12)_1_5_030609.pdf	Form
D-1 X13 2010 Experimental Questionnaire Version 13 (Coverage) D-1(X13)_1_2_D3_031209.pdf	Form
D-1 X14 2010 Experimental Questionnaire Version 14 (Race) D-1(X14)_1_2_031109.pdf	Form
D-1 X15 2010 Experimental Questionnaire Version 15 (Race) D-1(X15)_1_2_030609.pdf	Form
D-1 X16 2010 Experimental Questionnaire Version 16 (Race) D-1(X16)_1_2_031709.pdf	Form
D-1 X17 2010 Experimental Questionnaire Version 17 (Race) D-1(X17)_1_2_031009.pdf	Form
CPEX OMB Census 2010 Alternative Questionnaire_detailed OMB_041709_v2.doc 201 Census AQE Plan	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

201 Census Alternative Questionnaire Experiment

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	D-1 X6	2010 Experimental Questionnaire Version 6 (Race)	D-1(X6)_1_4_D3_030409.pdf	No	Paper Only
Form	D-1 X1	2010 Experimental Questionnaire Version 1 (Census 2000 form)	D-1(X1)_1_3_040809.pdf	No	Paper Only
Form	D-1 X2	2010 Experimental Questionnaire Version 2 (Combined Race/Hispanic Origin)	D-1(X2)_1_3_D2_031309.pdf	No	Paper Only
Form	D-1 X3	2010 Experimental Questionnaire Version 3 (Combined Race/Hispanic Origin)	D-1(X3)_1_2_022409.pdf	No	Paper Only
Form	D-1 X4	2010 Experimental Questionnaire Version 4 (Combined Race/Hispanic Origin)	D-1(X4)_1_3_022509.pdf	No	Paper Only
Form	D-1 X5	2010 Experimental Questionnaire Version 5 (Combined Race/Hispanic Origin)	D-1(X5)_1_2_022709.pdf	No	Paper Only
Form	D-1 X7	2010 Experimental Questionnaire Version 7 (Hispanic Origin)	D-1(X7)_1_5_022509.pdf	No	Paper Only
Form	D-1 X8	2010 Experimental Questionnaire Version 8 (Hispanic Origin)	D-1(X8)_1_6_D5_041509.pdf	No	Paper Only
Form	D-1 X9	2010 Experimental Questionnaire Version 9 (Race and Hispanic Origin)	D-1(X9)_1_2_D1_030409.pdf	No	Paper Only
Form	D-1 X10	2010 Experimental Questionnaire Version 10 (Race and Hispanic Origin)	D-1(X10)_1_3_030409.pdf	No	Paper Only
Form	D-1 X11	2010 Experimental Questionnaire Version 11 (Race and Hispanic Origin)	D-1(X11)_1_4_030609.pdf	No	Paper Only
Form	D-1 X12	2010 Experimental Questionnaire Version 12 (Hispanic Origin)	D-1(X12)_1_5_030609.pdf	No	Paper Only
Form	D-1 X15	2010 Experimental Questionnaire Version 15 (Race)	D-1(X15)_1_2_030609.pdf	No	Paper Only
Form	D-1 X16	2010 Experimental Questionnaire Version 16 (Race)	D-1(X16)_1_2_031709.pdf	No	Paper Only
Form	D-1 X17	2010 Experimental Questionnaire Version 17 (Race)	D-1(X17)_1_2_031009.pdf	No	Paper Only
Other-2010 CPEX IQ Return Envelope (no postal tracking)			D-8A(X1) Return Envelope for CPEX D2 040309.pdf	No	Paper Only
Other-2010 Experimental IQ Return Envelope (Coverage ï¿½ Must accommodate booklet form)			D-8B Update Leave Bilingual & CPEX Return Env Draft 3 03302009.pdf	No	Paper Only
Other-Standard 2010 IQ Cover Letter			D-16(L) MOMB Cover Letter D9 121208.pdf	No	Paper Only
Other-2010 Experimental IQ Cover Letter Version 1 (Coverage ï¿½ Potential size increase to match booklet)			D-16(L)(X1) CPEX Cover Letter D1_031809.pdf	No	Paper Only
Other-Standard 2010 Reminder Postcard			D-9 MOMB Reminder Postcard D6 121608.pdf	No	Paper Only
Other-Standard 2010 RQ Outgoing Envelope			D-6C(IN) Replacement Mail Outgoing Env Draft 4 03-24-09.pdf	No	Paper Only
Other-RQ Outgoing Flat Envelope (open window/accommodates booklet) ï¿½ Coverage			D-6B(X13) Outgoing RM for CPEX D1 040909.pdf	No	Paper Only
Other-2010 CPEX RQ Return Envelope (no postal tracking)			D-8C(IN) UL and Repl Return Env Draft 7 040309.pdf	No	Paper Only
Other-Standard 2010 RQ Cover Letter			D-17(L) MOMB Replacement Cover Ltr D9 121208.pdf	No	Paper Only
Other-2010 Experimental RQ Cover Letter Version 1 (Coverage ï¿½ Potential size increase to match booklet size)			D-17(L)(X1) CPEX Replacement Mailing Letter D1 03252009.pdf	No	Paper Only
Form	D-1 X13	2010 Experimental Questionnaire Version 13 (Coverage)	D-1(X13)_1_2_D3_031209.pdf	No	Paper Only
Form	D-1 X14	2010 Experimental Questionnaire Version 14 (Race)	D-1(X14)_1_2_031109.pdf	No	Paper Only
Other-Standard 2010 Advance Letter			D-5(L) MOMB Advance Letter D5 12-12-08.pdf	No	Paper Only
Other-Standard 2010 Advance Letter Envelope			D-5 Advance letter Env D4 03-30-09.pdf	No	Paper Only
Other-Standard 2010 IQ Outgoing Envelope			D-6A(IN) Initial MOMB Outgoing Env Draft 5 03-24-09.pdf	No	Paper Only
Other-Standard 2010 IQ Outgoing Flat Envelope (open window/accommodates booklet) ï¿½ Coverage			D-6B(AZ) MOMB Bilingual Outgoing Env Draft 3 03-24-09.pdf	No	Paper Only
Form	D-1 XA	Control A: Standard 2010 Questionnaire (including help line telephone number only for experimental cases)	D-1(XA)_1_3_040209.pdf	No	Paper Only
Form	D-1 XB	Control B: Standard 2010 Questionnaire without the overcount detection question (including help line telephone number only for experimental cases)	D-1(XB)_1_3_040209.pdf	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: 560,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	560,000	560,000
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
201 Census AQE Plan	CPEX OMB Census 2010 Alternative Questionnaire_detailed OMB_041709_v2.doc	05/11/2009

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