Information Collection

Cognitive Testing

IC 198392 under ICR 201203-1121-001 · OMB 1121-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DOJ survey 2B_r1.pdf	Other-Form: Mail Screener
DOJ survey 2C_r1.pdf	Other-Form: Mail Screener
NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx	Other-Interview Protocol
NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx	Other-Interview Protocol
Appendix B Informed Consent Form.pdf Informed Consent Form	IC Document
Appendix C Recruiting Advertisement Material.pdf Recruiting Advertisement Material	IC Document
Appendix D Recruiting Script and Screener.pdf Recruiting Script and Screener	IC Document
Appendix E Crime Scenarios for 2c Screener Testing.pdf Crime Scenarios for 2C Screener Testing	IC Document
NCVS-CS - Project Summary.docx NCVS CS Project Summary	IC Document
OMB_covermemo_cogs_Response_7 20.docx Qs and As between BJS and OMb	IC Document
OMB MEMO for NCVS Cognitive Testing Revised.pdf Justification memo to OMB	IC Document

IC Title:

Cognitive Testing

Agency IC Tracking Number:

BJS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Form: Mail Screener	DOJ survey 2B_r1.pdf	No	Paper Only
Other-Form: Mail Screener	DOJ survey 2C_r1.pdf	No	Paper Only
Other-Interview Protocol	NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx	No	Paper Only
Other-Interview Protocol	NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx	No	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	79	79
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Informed Consent Form	Appendix B Informed Consent Form.pdf	07/05/2011
Recruiting Advertisement Material	Appendix C Recruiting Advertisement Material.pdf	07/05/2011
Recruiting Script and Screener	Appendix D Recruiting Script and Screener.pdf	07/05/2011
Crime Scenarios for 2C Screener Testing	Appendix E Crime Scenarios for 2c Screener Testing.pdf	07/05/2011
NCVS CS Project Summary	NCVS-CS - Project Summary.docx	07/05/2011
Qs and As between BJS and OMb	OMB_covermemo_cogs_Response_7 20.docx	07/27/2011
Justification memo to OMB	OMB MEMO for NCVS Cognitive Testing Revised.pdf	07/27/2011

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