Information Collection

Special Census Program

IC 3416 under ICR 201206-0607-005 · OMB 0607-0368.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0368 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SC-1 Special Census Program	Form
SC-1 Special Census Enumerator Questionnaire Att A -- SC-1_Draft 21_040912[1] Latest A.pdf	Form
SC-1(PHONE/WYC) Special Census Phone/WYC Questionnaire Att C -- sc1_phoneWYC_Draft 2_021012[1] C.pdf	Form
SC-2 Individual Census Report Att D -- SC-2_Final Draft 05.10.12.D.pdf	Form
SC-116 Group Quarters Enumeration Control Record Att F -- sc116_Draft 10_040912[1]Latest F.pdf	Form
SC-351 Group Quarters Initial Contact Checklist AttG-SC351-5.pdf	Form
SC-920 Address Listing Page Att I -- SC-920.Address Listing Page I.pdf	Form
SC-921(HU) Housing Unit Add Page Att J -- SC-921hu[1].05.31.12 (XX.XX.XXXX).pdf	Form
SC-921(GQ) Group Quarters Add Page Att K -- SC-921(GQ) 05.10.12 K.pdf	Form
SC-921(TU) Transitory Unit Add Page Att L -- SC-921(TU) 06.07.12.L.pdf	Form
SC-117 Transitory Locations Enumeration Record Att G -- SC-117_Draft4_121511[1]Latest[1] G.pdf	Form
SC-3(RI) Enumeration Reinterview Form Att E -- SC-3(RI)_Draft 5_011312Latest[1].E.pdf	Form
SC-1SUPP Continuation Questionnaire Att B -- sc1(supp)_Draft 8_112911Latest - B.pdf	Form
SC-1(F) Information Sheet Att M -- SC-1F[1].06.08.12 M 06.08.12.pdf	Form
SC-31/SC-31(S) Group Quarters Information Sheet Att N -- SC-31 (E.S) 06.12.12.N.pdf	Form
SC-26 Notice of Visit Att O -- SC-26_doc[1] 06.07.12.O.pdf	Form
SC-901 Address Listing Notes Page Att P -- SC-901[1].06.07.12. P.pdf	Form
SC-3309 Language Identification Flashcard Att Q -- SC-3309[1] 05.15.12 Q.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Special Census Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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?	Electronic Capability
Form	SC-1	Special Census Enumerator Questionnaire	Att A -- SC-1_Draft 21_040912[1] Latest A.pdf	No	Paper Only
Form	SC-1(PHONE/WYC)	Special Census Phone/WYC Questionnaire	Att C -- sc1_phoneWYC_Draft 2_021012[1] C.pdf	No	Paper Only
Form	SC-2	Individual Census Report	Att D -- SC-2_Final Draft 05.10.12.D.pdf	No	Paper Only
Form	SC-116	Group Quarters Enumeration Control Record	Att F -- sc116_Draft 10_040912[1]Latest F.pdf	No	Paper Only
Form	SC-351	Group Quarters Initial Contact Checklist	AttG-SC351-5.pdf	No	Paper Only
Form	SC-920	Address Listing Page	Att I -- SC-920.Address Listing Page I.pdf	No	Paper Only
Form	SC-921(HU)	Housing Unit Add Page	Att J -- SC-921hu[1].05.31.12 (XX.XX.XXXX).pdf	No	Paper Only
Form	SC-921(GQ)	Group Quarters Add Page	Att K -- SC-921(GQ) 05.10.12 K.pdf	No	Paper Only
Form	SC-921(TU)	Transitory Unit Add Page	Att L -- SC-921(TU) 06.07.12.L.pdf	No	Paper Only
Form	SC-117	Transitory Locations Enumeration Record	Att G -- SC-117_Draft4_121511[1]Latest[1] G.pdf	No	Paper Only
Form	SC-3(RI)	Enumeration Reinterview Form	Att E -- SC-3(RI)_Draft 5_011312Latest[1].E.pdf	No	Paper Only
Form	SC-1SUPP	Continuation Questionnaire	Att B -- sc1(supp)_Draft 8_112911Latest - B.pdf	No	Paper Only
Form	SC-1(F)	Information Sheet	Att M -- SC-1F[1].06.08.12 M 06.08.12.pdf	No	Paper Only
Form	SC-31/SC-31(S)	Group Quarters Information Sheet	Att N -- SC-31 (E.S) 06.12.12.N.pdf	No	Paper Only
Form	SC-26	Notice of Visit	Att O -- SC-26_doc[1] 06.07.12.O.pdf	No	Paper Only
Form	SC-901	Address Listing Notes Page	Att P -- SC-901[1].06.07.12. P.pdf	No	Paper Only
Form	SC-3309	Language Identification Flashcard	Att Q -- SC-3309[1] 05.15.12 Q.pdf	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 248,430

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	248,430	248,430
Annual IC Time Burden (Hours)	53,527	53,527
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.