Information Collection

201 Census Alternative Questionnaire Experiment

IC 188914 under ICR 201103-0607-006 · OMB 0607-0952.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form D-1 XA Control A: Standard 2010 Questionnaire (including help line telephone number only for experimental cases) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 XB Control B: Standard 2010 Questionnaire without the overcount detection question (including help line telephone number only for experimental cases) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X1 2010 Experimental Questionnaire Version 1 (Census 2000 form) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X2 2010 Experimental Questionnaire Version 2 (Combined Race/Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X3 2010 Experimental Questionnaire Version 3 (Combined Race/Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X4 2010 Experimental Questionnaire Version 4 (Combined Race/Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X5 2010 Experimental Questionnaire Version 5 (Combined Race/Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X6 2010 Experimental Questionnaire Version 6 (Race) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X7 2010 Experimental Questionnaire Version 7 (Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X8 2010 Experimental Questionnaire Version 8 (Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X9 2010 Experimental Questionnaire Version 9 (Race and Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X10 2010 Experimental Questionnaire Version 10 (Race and Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X11 2010 Experimental Questionnaire Version 11 (Race and Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X12 2010 Experimental Questionnaire Version 12 (Hispanic Origin) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X13 2010 Experimental Questionnaire Version 13 (Coverage) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X14 2010 Experimental Questionnaire Version 14 (Race) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X15 2010 Experimental Questionnaire Version 15 (Race) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X16 2010 Experimental Questionnaire Version 16 (Race) 201 Census Alternative Questionnaire Experiment	Form
Form D-1 X17 2010 Experimental Questionnaire Version 17 (Race) 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.	Available Electronically?	Electronic Capability
Other-Standard 2010 Advance Letter		No	Paper Only
Other-Standard 2010 Advance Letter Envelope		No	Paper Only
Other-Standard 2010 IQ Outgoing Envelope		No	Paper Only
Other-Standard 2010 IQ Outgoing Flat Envelope (open window/accommodates booklet) ï¿½ Coverage		No	Paper Only
Form	D-1 XA	No	Paper Only
Form	D-1 XB	No	Paper Only
Form	D-1 X1	No	Paper Only
Form	D-1 X2	No	Paper Only
Form	D-1 X3	No	Paper Only
Form	D-1 X4	No	Paper Only
Form	D-1 X5	No	Paper Only
Form	D-1 X6	No	Paper Only
Form	D-1 X7	No	Paper Only
Form	D-1 X8	No	Paper Only
Form	D-1 X9	No	Paper Only
Form	D-1 X10	No	Paper Only
Form	D-1 X11	No	Paper Only
Form	D-1 X12	No	Paper Only
Form	D-1 X13	No	Paper Only
Form	D-1 X14	No	Paper Only
Form	D-1 X15	No	Paper Only
Form	D-1 X16	No	Paper Only
Form	D-1 X17	No	Paper Only
Other-2010 CPEX IQ Return Envelope (no postal tracking)		No	Paper Only
Other-2010 Experimental IQ Return Envelope (Coverage ï¿½ Must accommodate booklet form)		No	Paper Only
Other-Standard 2010 IQ Cover Letter		No	Paper Only
Other-2010 Experimental IQ Cover Letter Version 1 (Coverage ï¿½ Potential size increase to match booklet)		No	Paper Only
Other-Standard 2010 Reminder Postcard		No	Paper Only
Other-Standard 2010 RQ Outgoing Envelope		No	Paper Only
Other-RQ Outgoing Flat Envelope (open window/accommodates booklet) ï¿½ Coverage		No	Paper Only
Other-2010 CPEX RQ Return Envelope (no postal tracking)		No	Paper Only
Other-Standard 2010 RQ Cover Letter		No	Paper Only
Other-2010 Experimental RQ Cover Letter Version 1 (Coverage ï¿½ Potential size increase to match booklet size)		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		05/11/2009

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].