Cognitive pre-testing of a survey on record-keeping practices in the Survey of Occupational Injuries and Illnesses (SOII)

Cognitive and Psychological Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form Attachment 1 Cognitive pre-testing of a survey on record-keeping practices in the Survey of Occupational Injuries and Illnesses (SOII) Form
Attachment 1 Interviewer Protocol Attachment 1 - Interview Protocol.docx Form
Attachment 2 Screening Protocol Attachment 2 - Respondent screening protocol.docx Form
Note to Reviewer - SOII Recontact Survey.doc Note to Reviewer - SOII Recontact Survey IC Document

Information Collection (IC) Details

IC Title:	Cognitive pre-testing of a survey on record-keeping practices in the Survey of Occupational Injuries and Illnesses (SOII)	Agency IC Tracking Number:	21408

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
Form	Attachment 1	Interviewer Protocol	Attachment 1 - Interview Protocol.docx		Yes	No	Printable Only
Form	Attachment 2	Screening Protocol	Attachment 2 - Respondent screening protocol.docx		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Note to Reviewer - SOII Recontact Survey	Note to Reviewer - SOII Recontact Survey.doc	09/11/2014

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