Information Collection

Consumer Survey

IC 195101 under ICR 201011-3060-005 · OMB 3060-1144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3060-1144 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Consumer Survey	Form
Choosing Information From Your Media Environment: What a Consumer Survey (2010).pdf	Form
Choosing Information From Your Media Environment: What A Consumer Survey 2011.pdf	Form

IC Title:

Consumer Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Choosing Information From Your Media Environment: What are the Options?	Consumer Survey (2010).pdf		Yes	Yes	Fillable Fileable
Form	None	Choosing Information From Your Media Environment: What Are the Options?	Consumer Survey 2011.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

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	5,000	5,000
Annual IC Time Burden (Hours)	1,250	1,250
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.