Information Collection

2011 Field Test of the Re-engineered Survey of Income and Program Participation

IC 190057 under ICR 201009-0607-002 · OMB 0607-0957.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0957 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2011 Re-Engineered 2011 Field Test of the Re-engineered Survey of Income and Program Participation	Form
sipp105ldr2010.pdf	Other-Director's Letter
sipp105lspdr2010.pdf	Other-Director's Letter (Spanish)
sipp106ldr.pdf	Other-Change of Address Letter With
sipp107ldr.pdf	Other-Change of Address Letter Witho
Change Of Address Form - Attachment F.docx	Other-Change of Address Card
SIPP Brochure SIPP-4006A_2011 Attachment G.pdf	Other-SIPP Brochure
Respondent Rules Attachment H.pdf	Instruction
2011 Re-Engineered 2011 Re-Engineered SIPP Items Booklet 2011 ReSIPP Items Booklet.docx	Form

IC Title:

2011 Field Test of the Re-engineered Survey of Income and Program Participation

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2011 Re-Engineered SIPP Items Booklet	2011 Re-Engineered SIPP Items Booklet	2011 ReSIPP Items Booklet.docx	Yes	Yes	Fillable Fileable
Other-Director's Letter			sipp105ldr2010.pdf	No		Paper Only
Other-Director's Letter (Spanish)			sipp105lspdr2010.pdf	No		Paper Only
Other-Change of Address Letter With Incentive			sipp106ldr.pdf	No		Paper Only
Other-Change of Address Letter Without Incentive			sipp107ldr.pdf	No		Paper Only
Other-Change of Address Card			Change Of Address Form - Attachment F.docx	No		Paper Only
Other-SIPP Brochure			SIPP Brochure SIPP-4006A_2011 Attachment G.pdf	No		Paper Only
Instruction			Respondent Rules Attachment H.pdf	No		Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,670	7,670
Annual IC Time Burden (Hours)	5,681	5,681
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.