Information Collection

2012 Survey of Income and Program Participation Event History Calendar (SIPP-EHC) Field Test

IC 190057 under ICR 201108-0607-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 2012 SIPP-EHC Item 2012 Survey of Income and Program Participation Event History Calendar (SIPP-EHC) Field Test	Form
attachment b sipp-ehc-105(l)2012.docx	Other-Director's Letter
attachment c sipp-ehc-105(l)(sp)2012.docx	Other-Director's Letter (Spanish)
Attachment D Respondent Rules.pdf	Other-Respondent Rules
Attachment E SIPP-EHC-4006A (2012) You Rep Brochure.pdf	Other-Brochure "SIPP You Represent Y
2012 SIPP-EHC Item 2012 SIPP-EHC Items Booklet Attachment A 2012 SIPP-EHC Field Test Items Booklet.docx	Form

IC Title:

2012 Survey of Income and Program Participation Event History Calendar (SIPP-EHC) Field Test

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	2012 SIPP-EHC Items Booklet	2012 SIPP-EHC Items Booklet	Attachment A 2012 SIPP-EHC Field Test Items Booklet.docx	Yes	Yes	Fillable Fileable
Other-Director's Letter			attachment b sipp-ehc-105(l)2012.docx	Yes	Yes	Fillable Fileable
Other-Director's Letter (Spanish)			attachment c sipp-ehc-105(l)(sp)2012.docx	Yes	Yes	Fillable Fileable
Other-Respondent Rules			Attachment D Respondent Rules.pdf	Yes	Yes	Fillable Fileable
Other-Brochure "SIPP You Represent Your Nation"			Attachment E SIPP-EHC-4006A (2012) You Rep Brochure.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: 5,460

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	Previously Approved
Annual Number of Responses for this IC	5,460	-2,210	7,670
Annual IC Time Burden (Hours)	5,460	-221	5,681
Annual IC Cost Burden (Dollars)	0	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.