Information Collection

2012 National Census Test

IC 202002 under ICR 201204-0607-005 · OMB 0607-0970.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment B - DRAFT 2012 NCT Internet Screen Shots.pdf	Other-2012 National Census Test - In
Attachment C - DRAFT 2012 NCT Letters - UPDATE 06132012.pdf	Other-Various Respondent Letters
Attachment D - DRAFT 2012 NCT Internet Instruction Card.pdf	Other-Internet Access Instruction Ca
Attachment E - DRAFT 2012 NCT Instruction FAQ and Help Text.pdf	Other-FAQ and Help Text
Attachment F.docx	Other-Reinterview Specification
DA-1 2012 National Census Test (paper questionnaire) Attachment A - DRAFT 2012 NCT Paper Questionnaire.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Other-Reinterview Specification			Attachment F.docx	Yes	Yes	Fillable Fileable
Form	DA-1	2012 National Census Test (paper questionnaire)	Attachment A - DRAFT 2012 NCT Paper Questionnaire.pdf	No		Paper Only
Other-2012 National Census Test - Internet Screen Shots			Attachment B - DRAFT 2012 NCT Internet Screen Shots.pdf	Yes	Yes	Fillable Fileable
Other-Internet Access Instruction Card			Attachment D - DRAFT 2012 NCT Internet Instruction Card.pdf	Yes	Yes	Fillable Fileable
Other-FAQ and Help Text			Attachment E - DRAFT 2012 NCT Instruction FAQ and Help Text.pdf	Yes	Yes	Fillable Fileable
Other-Various Respondent Letters			Attachment C - DRAFT 2012 NCT Letters - UPDATE 06132012.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: 80,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	16,668	16,668
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.