Information Collection

Well-being Supplement to the American Time Use Survey

IC 198728 under ICR 201301-1220-002 · OMB 1220-0185.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0185 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
A - WBM questionnaire.doc	Other-CATI
C1 Advance letter.pdf Attachment C1 - Advance Letter	IC Document
C2 Advance letter_incentive cases.pdf Attachment C2 - Advance Letter, Incentive	IC Document
C3 Advance Brochure.pdf Attachment C3 - Advance Brochure	IC Document
J1 refusal conv_confidentiality.doc Attachment J1 - Refusal Conversion, Confidentiality	IC Document
J2 refusal conv_why me.doc Attachment J2 - Refusal Conversion, Why Me	IC Document
J3 refusal conv_tired CPS.doc Attachment J3 - Refusal Conversion, Tired CPS	IC Document
J4 refusal conv_too busy.doc Attachment J4 - Refusal Conversion, Too Busy	IC Document
J5 refusal conv_gatekeeper.doc Attachment J5 - Refusal Conversion, Gatekeeper	IC Document

IC Title:

Well-being Supplement to the American Time Use Survey

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-CATI			A - WBM questionnaire.doc		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: 12,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,800	-6,400	19,200
Annual IC Time Burden (Hours)	1,067	-533	1,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment C1 - Advance Letter	C1 Advance letter.pdf	01/03/2013
Attachment C2 - Advance Letter, Incentive	C2 Advance letter_incentive cases.pdf	01/03/2013
Attachment C3 - Advance Brochure	C3 Advance Brochure.pdf	01/03/2013
Attachment J1 - Refusal Conversion, Confidentiality	J1 refusal conv_confidentiality.doc	01/03/2013
Attachment J2 - Refusal Conversion, Why Me	J2 refusal conv_why me.doc	01/03/2013
Attachment J3 - Refusal Conversion, Tired CPS	J3 refusal conv_tired CPS.doc	01/03/2013
Attachment J4 - Refusal Conversion, Too Busy	J4 refusal conv_too busy.doc	01/03/2013
Attachment J5 - Refusal Conversion, Gatekeeper	J5 refusal conv_gatekeeper.doc	01/03/2013

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