Information Collection

2012 SIPP CARI Field Test

IC 200162 under ICR 201111-0607-001 · OMB 0607-0968.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A 2012 SIPP CARI, Selected Questions for Audio Recording.docx	Other-2012 SIPP CARI Selected Questi
Attachment B 2012 SIPP CARI Instrument Booklet, Entire Interview.docx	Other-2012 SIPP CARI Entire Intervie
Attachment C SIPP-CARI-105(L)(DR) 2012 ENGLISH letter.docx	Other-2012 SIPP CARI Director's Lett
Attachment D SIPP-CARI-105(L)(SP)(DR)2012 SPANISH letter.docx	Other-2012 SIPP CARI Director's Lett
Attachment E Respondent Rules.pdf	Other-Respondent Rules
Attachment F SIPP-EHC-4006A (2012) You Rep Brochure.pdf	Other-Brochuere: "SIPP You Represent

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?	Can Be Submitted Electronically?	Electronic Capability
Other-2012 SIPP CARI Selected Questions for Audio Recording	Attachment A 2012 SIPP CARI, Selected Questions for Audio Recording.docx	Yes	Yes	Fillable Fileable
Other-2012 SIPP CARI Entire Interview Script	Attachment B 2012 SIPP CARI Instrument Booklet, Entire Interview.docx	Yes	Yes	Fillable Fileable
Other-2012 SIPP CARI Director's Letter	Attachment C SIPP-CARI-105(L)(DR) 2012 ENGLISH letter.docx	Yes	Yes	Fillable Fileable
Other-2012 SIPP CARI Director's Letter (Spanish)	Attachment D SIPP-CARI-105(L)(SP)(DR)2012 SPANISH letter.docx	Yes	Yes	Fillable Fileable
Other-Respondent Rules	Attachment E Respondent Rules.pdf	Yes	Yes	Fillable Fileable
Other-Brochuere: "SIPP You Represent Your Nation"	Attachment F 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: 1,890

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
Annual Number of Responses for this IC	1,890	1,890
Annual IC Time Burden (Hours)	1,890	1,890
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.