Information Collection

CE Globals Cognitive Study

IC 202924 under ICR 201111-1220-001 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Background Questio CE Globals Cognitive Study	Form and Instruction
Background Questio CE Globals Study Background Questions Attachment A - Background Questions.docx	Form and Instruction
Attachment B Interviewer Administered Cognitive Protocol Attachment B - Interviewer Administered Cognitive Protocol.docx	Form and Instruction
Attachment C Self Administered Survey for lab and web participants Attachment C - Self Administered Survey for lab and web participants.docx	Form and Instruction
Attachment D Self Administered Web Survey Attachment D - Self Administered Web Survey.docx	Form and Instruction
Globals 2012 OMB Package 2.docx CE Globals Cognitive Study Request	IC Document

IC Title:

CE Globals Cognitive Study

Agency IC Tracking Number:

21208

IC Status: New

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 and Instruction	Background Questions	CE Globals Study Background Questions	Attachment A - Background Questions.docx	No		Paper Only
Form and Instruction	Attachment B	Interviewer Administered Cognitive Protocol	Attachment B - Interviewer Administered Cognitive Protocol.docx	Yes	No	Fillable Printable
Form and Instruction	Attachment C	Self Administered Survey for lab and web participants	Attachment C - Self Administered Survey for lab and web participants.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Attachment D	Self Administered Web Survey	Attachment D - Self Administered Web Survey.docx	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: 80

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CE Globals Cognitive Study Request	Globals 2012 OMB Package 2.docx	06/28/2012

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