2012 Well-being module

Well-being Supplement to the American Time Use Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0185 can be found here:

Documents and Forms

Document Name Document Type
A - WBM questionnaire.doc Other-CATI
C1 Advance letter.pdf Advance letter IC Document
C2 Advance letter_incentive cases.pdf Advance letter incentive cases IC Document
C3 Advance Brochure.pdf Advance Brochure IC Document
J1 refusal conv_confidentiality.doc refusal conv_confidentiality IC Document
J2 refusal conv_why me.doc refusal conv_why me IC Document
J3 refusal conv_tired CPS.doc refusal conv_tired CPS IC Document
J4 refusal conv_too busy.doc refusal conv_too busy IC Document
J5 refusal conv_gatekeeper.doc refusal conv_gatekeeper IC Document

Information Collection (IC) Details

IC Title:	2012 Well-being module	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-CATI			A - WBM questionnaire.doc		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: 12,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,800	12,800
Annual IC Time Burden (Hours)	1,067	1,067
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Advance letter	C1 Advance letter.pdf	08/02/2011
Advance letter incentive cases	C2 Advance letter_incentive cases.pdf	08/02/2011
Advance Brochure	C3 Advance Brochure.pdf	08/02/2011
refusal conv_confidentiality	J1 refusal conv_confidentiality.doc	08/02/2011
refusal conv_why me	J2 refusal conv_why me.doc	08/02/2011
refusal conv_tired CPS	J3 refusal conv_tired CPS.doc	08/02/2011
refusal conv_too busy	J4 refusal conv_too busy.doc	08/02/2011
refusal conv_gatekeeper	J5 refusal conv_gatekeeper.doc	08/02/2011

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