02/17/09 DRAFT
Attachment to OMB Form 83i
Generic Clearance for the 2010 Census Program for Evaluations and Experiments
List of Agency Form Numbers
(2010 Alternative Questionnaire Experiment (AQE), 2010 Deadline Messaging/Compressed Schedule (DM/CS) Experiment, 2010 Privacy Notification (PN) Experiment)
Type of Form |
Form Number |
Form Description |
Applicable Data Collection(s) |
Advance Letter |
D-5L |
Standard 2010 Advance Letter |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-5L X1 |
2010 AL Experimental Version 1 (mild deadline message with April 5 due date in body of letter) |
2010 DM/CS |
|
D-5L X4 |
2010 AL Experimental Version 2 (Standard 2010 AL text with date of letter later due to compressed schedule) |
2010 DM/CS |
|
D-5L X5 |
2010 AL Experimental Version 4 (mild deadline message with April 5 due date in body of letter and date of letter later due to compressed schedule) |
2010 DM/CS |
|
|
|
|
Advance Letter Envelope |
D-5 |
Standard 2010 Advance Letter Envelope |
2010 AQE; 2010 DM/CS; 2010 PN |
|
|
|
|
Initial Questionnaire Outgoing Envelope |
D-6A (IN) |
Standard 2010 IQ Outgoing Envelope |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-6B X13 |
IQ Outgoing Flat Envelope (open window/accommodates booklet) – Coverage |
2010 AQE |
|
D-6A X14 |
IQ Outgoing Envelope (open window with Deadline Message 1, 3 and 4 – “Mail by April 5”) – Deadline Message |
2010 DM/CS |
|
D-6A X15 |
IQ Outgoing Envelope (open window with Deadline Message 2 – “Deadline is April 5”) – Deadline Message |
2010 DM/CS |
|
|
|
|
Initial Questionnaires |
D-1 XA |
Control A: Standard 2010 Questionnaire (including help line telephone number only for experimental cases) |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-1 XB |
Control B: Standard 2010 Questionnaire without the overcount detection question (including help line telephone number only for experimental cases) |
2010 AQE |
|
D-1 X1 |
2010 Experimental Questionnaire Version 1 (Census 2000 form) |
2010 AQE |
|
D-1 X2 |
2010 Experimental Questionnaire Version 2 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X3 |
2010 Experimental Questionnaire Version 3 (Combined Race/Hispanic Origin)
|
2010 AQE |
|
D-1 X4 |
2010 Experimental Questionnaire Version 4 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X5 |
2010 Experimental Questionnaire Version 5 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X6 |
2010 Experimental Questionnaire Version 6 (Race) |
2010 AQE |
|
D-1 X7 |
2010 Experimental Questionnaire Version 7 (Hispanic Origin) |
2010 AQE |
|
D-1 X8 |
2010 Experimental Questionnaire Version 8 (Hispanic Origin) |
2010 AQE |
|
D-1 X9 |
2010 Experimental Questionnaire Version 9 (Race and Hispanic Origin)
|
2010 AQE |
|
D-1 X10 |
2010 Experimental Questionnaire Version 10 (Race and Hispanic Origin) |
2010 AQE |
|
D-1 X11 |
2010 Experimental Questionnaire Version 11 (Race and Hispanic Origin) |
2010 AQE |
|
D-1 X12 |
2010 Experimental Questionnaire Version 12 (Hispanic Origin) |
2010 AQE |
|
D-1 X13 |
2010 Experimental Questionnaire Version 13 (Coverage) |
2010 AQE |
|
D-1 X14 |
2010 Experimental Questionnaire Version 14 (Race) |
2010 AQE |
|
D-1 X15 |
2010 Experimental Questionnaire Version 15 (Race) |
2010 AQE |
|
D-1 X16 |
2010 Experimental Questionnaire Version 16 (Race) |
2010 AQE |
|
D-1 X17 |
2010 Experimental Questionnaire Version 17 (Race) |
2010 AQE |
|
|
|
|
Initial Questionnaire Return Envelope |
D-8A X1 |
2010 CPEX IQ Return Envelope (no postal tracking) |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-8B |
2010 Experimental IQ Return Envelope (Coverage – Must accommodate booklet form) |
2010 AQE |
|
|
|
|
Initial Questionnaire Cover Letter |
D-16L |
Standard 2010 IQ Cover Letter |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-16L X1 |
2010 Experimental IQ Cover Letter Version 1 (Coverage – Potential size increase to match booklet) |
2010 AQE |
|
D-16L X2 |
2010 Experimental IQ Cover Letter Version 2 (Deadline Message 1) |
2010 DM/CS |
|
D-16L X3 |
2010 Experimental IQ Cover Letter Version 3 (Deadline Message 2)
|
2010 DM/CS |
|
D-16L X4 |
2010 Experimental IQ Cover Letter Version 4 (Deadline Message 3) |
2010 DM/CS |
|
D-16L X5 |
2010 Experimental IQ Cover Letter Version 5 (Compressed Schedule with header date change) |
2010 DM/CS |
|
D-16L X6 |
2010 Experimental IQ Cover Letter Version 6 (Deadline Message 1 + Compressed Schedule with header date change) |
2010 DM/CS |
|
D-16L X7 |
2010 Experimental IQ Cover Letter Version 7 (Deadline Message 2 + Compressed Schedule with header date change) |
2010 DM/CS |
|
D-16L X8 |
2010 Experimental IQ Cover Letter Version 8 (Deadline Message 3 + Compressed Schedule with header date change) |
2010 DM/CS |
|
D-16L X9 |
2010 Experimental IQ Cover Letter Version 9 (Privacy Message 1) |
2010 PN |
|
D-16L X10 |
2010 Experimental IQ Cover Letter Version 10 (Privacy Message 2) |
2010 PN |
|
D-16L X11 |
2010 Experimental IQ Cover Letter Version 11 (Deadline Message 4)
|
2010 DM/CS |
|
D-16L X12 |
2010 Experimental IQ Cover Letter Version 12 (Deadline Message 4 + Compressed Schedule with header date change) |
2010 DM/CS |
|
|
|
|
Reminder Postcard |
D-9 |
Standard 2010 Reminder Postcard |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-9 X1 |
2010 Experimental RP Version 1 (Deadline Message 1) |
2010 DM/CS |
|
D-9 X2 |
2010 Experimental RP Version 2 (Deadline Message 2) |
2010 DM/CS |
|
D-9 X3 |
2010 Experimental RP Version 3 (Deadline Message 3) |
2010 DM/CS |
|
D-9 X4 |
2010 Experimental RP Version 4 (Compressed Schedule with header date change) |
2010 DM/CS |
|
D-9 X5 |
2010 Experimental RP Version 5 (Deadline Message 1 + Compressed schedule with header date change) |
2010 DM/CS |
|
D-9 X6 |
2010 Experimental RP Version 6 (Deadline Message 2 + Compressed schedule with header date change) |
2010 DM/CS |
|
D-9 X7 |
2010 Experimental RP Version 7 (Deadline Message 3 + Compressed schedule with header date change) |
2010 DM/CS |
|
D-9 X8 |
2010 Experimental RP Version 8 (Deadline Message 4)
|
2010 DM/CS |
|
D-9 X9 |
2010 Experimental RP Version 9 (Deadline Message 4 + Compressed schedule with header date change) |
2010 DM/CS |
|
|
|
|
Replacement Questionnaire Outgoing Envelope |
D-6A (IN) |
Standard 2010 RQ Outgoing Envelope |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-6B X13 |
RQ Outgoing Flat Envelope (open window/accommodates booklet) – Coverage |
2010 AQE |
|
|
|
|
Replacement Questionnaires |
D-1 XA |
Control A: Standard 2010 Questionnaire (with CPEX phone numbers) |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-1 XB |
Control B: Standard 2010 Questionnaire without the overcount detection question (with CPEX phone numbers) |
2010 AQE |
|
D-1 X1 |
2010 Experimental Questionnaire Version 1 (Census 2000 form) |
2010 AQE |
|
D-1 X2 |
2010 Experimental Questionnaire Version 2 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X3 |
2010 Experimental Questionnaire Version 3 (Combined Race/Hispanic Origin)
|
2010 AQE |
|
D-1 X4 |
2010 Experimental Questionnaire Version 4 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X5 |
2010 Experimental Questionnaire Version 5 (Combined Race/Hispanic Origin) |
2010 AQE |
|
D-1 X6 |
2010 Experimental Questionnaire Version 6 (Race) |
2010 AQE |
|
D-1 X7 |
2010 Experimental Questionnaire Version 7 (Hispanic Origin) |
2010 AQE |
|
D-1 X8 |
2010 Experimental Questionnaire Version 8 (Hispanic Origin) |
2010 AQE |
|
D-1 X9 |
2010 Experimental Questionnaire Version 9 (Race and Hispanic Origin) |
2010 AQE |
|
D-1 X10 |
2010 Experimental Questionnaire Version 10 (Race and Hispanic Origin) |
2010 AQE |
|
D-1 X11 |
2010 Experimental Questionnaire Version 11 (Race and Hispanic Origin) |
2010 AQE |
|
D-1 X12 |
2010 Experimental Questionnaire Version 12 (Hispanic Origin) |
2010 AQE |
|
D-1 X13 |
2010 Experimental Questionnaire Version 13 (Coverage)
|
2010 AQE |
|
D-1 X14 |
2010 Experimental Questionnaire Version 14 (Race) |
2010 AQE |
|
D-1 X15 |
2010 Experimental Questionnaire Version 15 (Race) |
2010 AQE |
|
D-1 X16 |
2010 Experimental Questionnaire Version 16 (Race) |
2010 AQE |
|
D-1 X17 |
2010 Experimental Questionnaire Version 17 (Race) |
2010 AQE |
|
|
|
|
Replacement Questionnaire Return Envelope |
D-8A X1 |
2010 CPEX RQ Return Envelope (no postal tracking) |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-8B |
2010 Experimental RQ Return Envelope (Coverage – Must accommodate booklet form) |
2010 AQE |
|
|
|
|
Replacement Questionnaire Cover Letter |
D-17L |
Standard 2010 RQ Cover Letter |
2010 AQE; 2010 DM/CS; 2010 PN |
|
D-17L X1 |
2010 Experimental RQ Cover Letter Version 1 (Coverage – Potential size increase to match booklet size) |
2010 AQE |
|
D-17L X2 |
2010 Experimental RQ Cover Letter Version 2 (Privacy Message 1) |
2010 PN |
|
D-17L X3 |
2010 Experimental RQ Cover Letter Version 3 (Privacy Message 2) |
2010 PN |
Interviewer/Enumerator Assisted Data Collections
(2010 Alternative Questionnaire Experiment (AQE) Reinterview Evaluation, 2010 Content Reinterview Evaluation, 2010 NRFU Contact Strategy Experiment, 2010 Group Quarters Questionnaire Evaluation, 2010 Interactive Voice Response (IVR)Customer Satisfaction Survey Evaluation)
Type of Form |
Form Number |
Form Description |
Applicable Data Collection(s) |
Notification Letter |
Not Yet Assigned |
AQE Reinterview/AQE Content Reinterview Notification (English) |
2010 AQE Reinterivew; 2010 Content Reinterview |
|
Not Yet Assigned |
AQE Reinterview/AQE Content Reinterview Notification (Spanish) |
2010 AQE Reinterivew; 2010 Content Reinterview |
|
|
|
|
Notification Letter Envelope |
Not Yet Assigned |
Envelope for notification letter |
2010 AQE Reinterivew; 2010 Content Reinterview |
|
|
|
|
Reinterview Questionnaire |
Not Yet Assigned |
AQE Reinterview Questionnaire 1 - Separate Race and Hispanic Origin Question (English) |
2010 AQE Reinterivew |
|
Not Yet Assigned |
AQE Reinterview Questionnaire 1 - Separate Race and Hispanic Origin Question (Spanish) |
2010 AQE Reinterivew |
|
Not Yet Assigned |
AQE Reinterview Questionnaire 2 - Combined Race and Hispanic Origin Question (English) |
2010 AQE Reinterivew |
|
Not Yet Assigned |
AQE Reinterview Questionnaire 2 - Combined Race and Hispanic Origin Question (English) |
2010 AQE Reinterivew |
|
Not Yet Assigned |
AQE Content Reinterview Questionnaire (English) |
2010 Content Reinterview |
|
Not Yet Assigned |
AQE Content Reinterview Questionnaire (Spanish) |
2010 Content Reinterview |
|
|
|
|
Experimental Enumerator Form |
D1–(E) X1 |
Enumerator questionnaire experimental version with space for four contacts |
2010 NRFU Contact Strategy Experiment |
|
D1– (E) X2 |
Enumerator questionnaire experimental version with space for five contacts |
2010 NRFU Contact Strategy Experiment |
|
|
|
|
Experimental Individual Census Report (Group Quarters Enumeration) |
D20 X1 |
Group quarters enumeration questionnaire experimental version allowing the collection of a usual home elsewhere for all respondents |
2010 Group Quarters Questionnaire Evaluation |
|
|
|
|
Interactive Voice Response Customer Satisfaction Questionnaire |
Not Assigned (electronic collection) |
Customer satisfaction questionnaire 1 for callers who end call in IVR self-help application |
2010 IVR Customer Satisfaction Survey Evaluation |
|
Not Assigned (electronic collection) |
Customer satisfaction questionnaire 2 for callers who are transferred from the self-help IVR application to a live customer service representative |
2010 IVR Customer Satisfaction Survey Evaluation |
| File Type | application/msword |
| File Title | AQE D-1 through D-1(X13) [initial questionnaires] |
| Author | love0313 |
| Last Modified By | love0313 |
| File Modified | 2009-02-17 |
| File Created | 2009-02-17 |