Information Collection

Census Partnership Program Focus Groups and Interviews

IC 196911 under ICR 201103-0607-005 · OMB 0607-0965.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PartnershipResearchAppendixA-2011-03-18.docx	Other-Focus Group Screening Form
PartnershipResearchAppendixB-2011-03-02.docx	Other-Focus Group Consent Form
PartnershipResearchAppendixC-2011-03-02.docx	Other-Focus Group Protocol and Moder
PartnershipResearchAppendixD-2011-03-02.docx	Other-Focus Group Acknowledgement of
PartnershipResearchAppendixE-2011-03-18.docx	Other-Interview Telephone Screener
PartnershipResearchAppendixF-2011-03-18.docx	Other-Interview Questionnaire
PartnershipResearchAppendixG-2011-03-02.docx	Other-Prospective Partner Interview
PartnershipResearchAppendixH-2011-03-02.docx	Other-Prospective Partner Interview

IC Title:

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	Instrument File	Available Electronically?	Electronic Capability
Other-Focus Group Screening Form	PartnershipResearchAppendixA-2011-03-18.docx	No	Paper Only
Other-Focus Group Consent Form	PartnershipResearchAppendixB-2011-03-02.docx	No	Paper Only
Other-Focus Group Protocol and Moderator's Guide	PartnershipResearchAppendixC-2011-03-02.docx	No	Paper Only
Other-Focus Group Acknowledgement of Receipt of Payment	PartnershipResearchAppendixD-2011-03-02.docx	No	Paper Only
Other-Interview Telephone Screener	PartnershipResearchAppendixE-2011-03-18.docx	No	Paper Only
Other-Interview Questionnaire	PartnershipResearchAppendixF-2011-03-18.docx	No	Paper Only
Other-Prospective Partner Interview Telephone Screener	PartnershipResearchAppendixG-2011-03-02.docx	No	Paper Only
Other-Prospective Partner Interview Questionnaire	PartnershipResearchAppendixH-2011-03-02.docx	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	120	120
Annual IC Time Burden (Hours)	150	150
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.