Information Collection

Field Test of Self-Administered Survey Modes

IC 200588 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⚠️ Notice: This information collection may be referencing outdated material.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
Field Test of Self-Administered Survey Modes	Form
Address Verification and Household Enumeration Questionn Attachment 3 CATI-CAPI Address Verif HH Enumeration Quex 2-9-2012.docx	Form
Web Survey Attachment 5 Web Survey 2-9-2012.docx	Form
Attachment_2_Cognitive_Test_Report.pdf Cognitive Test Report	IC Document
Attachment_6_Literature_Review.pdf Literature Review	IC Document
Attachment_7_SCV_Design_Development.pdf SCV Design Development	IC Document
Attachment_8_Overview_of_SCV_Design.pdf Overview of SCV Design	IC Document
Attachment_9_ABS_Sampling.pdf ABS Sampling	IC Document
Attachment_10_Staff_Recruiting_Training_Monitoring.pdf Staff Recruiting and Training	IC Document
Attachment_12_Data_Security.pdf Data Security	IC Document
Attachment_13_Distressed_Respondent_Protocol.pdf Distressed Respondent Protocol	IC Document
Attachment_14_References.pdf References	IC Document
Attachment 1 Incentives 2-9-2012.docx Attachment 1 -- Incentives	IC Document
Field Test OMB Memo 12-16-2011.docx Field Test Memo	IC Document
NCVS mixed mode passback response 2-9-2012.docx Passback Q and A document	IC Document
Attachment 4a CATI CAPI Screener 2-9-2012.pdf Attachment 4a CATI CAPI screener	IC Document
Attachment 4b CATI CAPI Crime Incident Report 2-9-2012 .pdf Attachment 4b CATI CAPI incident report	IC Document
Attachment 11 Contacting Addresses Gaining Cooperation 2-9-2012.pdf Attachment 11 -- contacting addresses/gaining cooperation	IC Document

IC Title:

Field Test of Self-Administered Survey Modes

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Address Verification and Household Enumeration Questionnaire	Attachment 3 CATI-CAPI Address Verif HH Enumeration Quex 2-9-2012.docx		Yes	Yes	Fillable Fileable
Form	None	Web Survey	Attachment 5 Web Survey 2-9-2012.docx		Yes	Yes	Fillable Fileable

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: 6,125

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	6,125	6,125
Annual IC Time Burden (Hours)	1,786	1,786
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cognitive Test Report	Attachment_2_Cognitive_Test_Report.pdf	12/22/2011
Literature Review	Attachment_6_Literature_Review.pdf	12/22/2011
SCV Design Development	Attachment_7_SCV_Design_Development.pdf	12/22/2011
Overview of SCV Design	Attachment_8_Overview_of_SCV_Design.pdf	12/22/2011
ABS Sampling	Attachment_9_ABS_Sampling.pdf	12/22/2011
Staff Recruiting and Training	Attachment_10_Staff_Recruiting_Training_Monitoring.pdf	12/22/2011
Data Security	Attachment_12_Data_Security.pdf	12/22/2011
Distressed Respondent Protocol	Attachment_13_Distressed_Respondent_Protocol.pdf	12/22/2011
References	Attachment_14_References.pdf	12/22/2011
Attachment 1 -- Incentives	Attachment 1 Incentives 2-9-2012.docx	02/21/2012
Field Test Memo	Field Test OMB Memo 12-16-2011.docx	02/21/2012
Passback Q and A document	NCVS mixed mode passback response 2-9-2012.docx	02/21/2012
Attachment 4a CATI CAPI screener	Attachment 4a CATI CAPI Screener 2-9-2012.pdf	02/21/2012
Attachment 4b CATI CAPI incident report	Attachment 4b CATI CAPI Crime Incident Report 2-9-2012 .pdf	02/21/2012
Attachment 11 -- contacting addresses/gaining cooperation	Attachment 11 Contacting Addresses Gaining Cooperation 2-9-2012.pdf	02/21/2012

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