Focus Groups

Focus Groups and Survey Regarding Pension Benefit Statements

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0151 can be found here:

Documents and Forms

Document Name Document Type
Focus Group Discussion Guide 5-28-13.docx Other-Focus Group Discussion Guide
Sample Statement V1 5-28-13.docx Other-Sample Statement version 1
Sample Statement V2 5-28-13.docx Other-Sample Statement Version 2
Sample Statement V3 5-28-13.docx Other-Sample Statement Version 3
Informed Consent Statement 8-1-13.docx Other-Informed Consent Statement

Information Collection (IC) Details

IC Title:	Focus Groups	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Focus Group Discussion Guide	Focus Group Discussion Guide 5-28-13.docx	No	Paper Only
Other-Sample Statement version 1	Sample Statement V1 5-28-13.docx	No	Printable Only
Other-Sample Statement Version 2	Sample Statement V2 5-28-13.docx	No	Printable Only
Other-Sample Statement Version 3	Sample Statement V3 5-28-13.docx	No	Printable Only
Other-Informed Consent Statement	Informed Consent Statement 8-1-13.docx	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.