Generic Clearance for Questionnaire Pretesting Research

Forms and Documents

Document Name	Status
Form Protocol NACS for 2017 Economic Census: Round 3 Form and Instruction	New
Form Protocol 2017 Commodity Flow Survey (CFS) Web questionnaire Form and Instruction	New
Form Demographics 2017 Census Test Usability Testing Form and Instruction	New
Form AHS Protocol AHS Revised Modules Cog Testing Form and Instruction	New
Form DY-1W-TE1 AIAN Enrollment Questions Form	New
Form H-100 2016 NYCHVS Spanish Translation Research Form	New
Form NEW FGP questions Factoryless Goods Producers for 2017 Economic Census Form	New
Form Internet Group 2 V 2016 American Community Survey Respondent Burden Testing Form and Instruction	New
Form Demographics Mobile UI Design Framework for Survey Operations – Phase 1, Study 1 Form and Instruction	New
Form Puerto Rico Group Puerto Rico Group Quarters Electronic Transfer Capability Survey Form and Instruction	New
Form BRDIS Protocol 2016 Business R&D and Innovation Survey (BRDIS) Form and Instruction	New
Form SBLS Protocol 2015 Small Business Lending Survey (SBLS) Form and Instruction	New
Form Student Housing Pr 2016 Census Student Housing Definition Group Quarters Form and Instruction	New
Form ASM-RO Debriefing 2015 ASM-RO Worksheet Prototype Debriefings Form and Instruction	New
Form ASM Debriefing Respondent debriefings - Web instrument - 2015 Annual Survey of Manufactures (ASM) Form and Instruction	New
Form 2016 Census Test p 2016 Census Test online questionnaire non-English testing Form and Instruction	New
Form AI Screener AIAN Tribal Enrollment Form	New
Form 2016 ASC Business 2016 ASE Form	New
Form 2016 NRFU 2016 COMPASS NRFU Form and Instruction	New
Form Internet Screener FY16 Generic Screeners Form	New
Form Satisfaction Quest Census User Identification Codes Usability Testing Form	New
Form CFS-1000 2017 Commodity Flow Survey Pretest Form and Instruction	New
Form D1-F DRAFT 2020 Census Billinugal Vietnamese, Russian, and Arabic Form	New
Form DF-1 E 2020 Chinese Korean Bilingual Forms Form and Instruction	New
Form ACE-1 (Long) Questionnaire Pretesting Research - ECON Hub Business Unit Harmonization Team Form and Instruction	New
Form DC3309 Decennial Language Research Form and Instruction	New
nonsubstantive change request $25 for minors.docx Justification for No Material/Nonsubstantive Change	2013-12-16
OMB Memos under the Generic Clearance -- key elements_FINAL.docx Supplementary Document	2013-09-30
13genclrAttachmentB.doc Supplementary Document	2013-06-05
13genclrattachment A.doc Supplementary Document	2013-06-05
13genclrpartB.doc Supporting Statement B	2013-06-05
13genclrpartA_nonsubstantive change.doc Supporting Statement A	2013-12-16

IC Document Collections

IC ID	Document Title	Status
222012	2017 Economic Census New Questions Instruction	New
221987	NACS for 2017 Economic Census: Round 3 Form and Instruction	New
221985	2017 Commodity Flow Survey (CFS) Web questionnaire Form and Instruction	New
221984	2017 Census Test Usability Testing Form and Instruction	New
221896	SCOPE Confidentiality Language Testing Instruction	New
221886	2016 Annual Survey of Manufactures and 2016 Report of Organization Instruction	New
221659	AHS Revised Modules Cog Testing Form and Instruction	New
221552	AIAN Enrollment Questions Form	New
221546	2016 NYCHVS Spanish Translation Research Form	New
221303	Factoryless Goods Producers for 2017 Economic Census Form	New
221263	2016 American Community Survey Respondent Burden Testing Form and Instruction	New
221080	Mobile UI Design Framework for Survey Operations – Phase 1, Study 1 Form and Instruction	New
220990	American Housing Survey Contact and Incentive Focus Groups Instruction	New
220989	2017 Puerto Rico Census Focus Group Pretesting Instruction	New
220601	Usability of the 2017 National Survey of College Graduates (NSCG) online questionnaire Instruction	New
220596	Puerto Rico Group Quarters Electronic Transfer Capability Survey Form and Instruction	New
220324	2016 Business R&D and Innovation Survey (BRDIS) Form and Instruction	New
220323	2015 Small Business Lending Survey (SBLS) Form and Instruction	New
220049	2016 Census Student Housing Definition Group Quarters Form and Instruction	New
219595	2015 ASM-RO Worksheet Prototype Debriefings Form and Instruction	New
219563	Respondent debriefings - Web instrument - 2015 Annual Survey of Manufactures (ASM) Form and Instruction	New
219325	MOPS Usability Testing Instruction	New
219313	NSCG Contact Materials	New
219177	2016 Census Test online questionnaire non-English testing Form and Instruction	New
219050	AIAN Tribal Enrollment Form	New
218830	2016 ASE Form	New
218733	2016 COMPASS NRFU Form and Instruction	New
218731	FY16 Generic Screeners Form	New
218707	Census User Identification Codes Usability Testing Form	New
218201	Census Business Builder Online Tool Instruction	New
218095	2017 Commodity Flow Survey Pretest Form and Instruction	New
218011	2020 Census Billinugal Vietnamese, Russian, and Arabic Form	New
217853	2020 Chinese Korean Bilingual Forms Form and Instruction	New
217795	NCVS SVS Other-Pretesting Questionnaire	New
217438	2016 Census Letter Cognitive Testing Other-Draft Cognitive Testing Package - Reingold Version	New
217372	State Government Research and Development (SGRD) Other-SGRD Usability Testing Draft Protocol	New
217301	Factoryless Goods Producers (FGP) Other-Enterprise FGP Concept Early Stage Scoping Protocol	New
217098	Annual Survey of Entrepreneurs Other-Online Survey Instrument	New
217096	North American Products Classification System (NAPCS) Other-Enclosure 1 - Research Questions	New
217095	Federal Deposit Insurance Corporation's Survey Other-Enclosure 1 - Screener	New
217038	Group Quarters Electronic Transfer Capability Survey (GQETCS) Other-GQETCS Online Instrument	New
216878	2015 Management and Organizational Practices Survey (MOPS) Other-Research Questions	New
216847	2015 National Content Test Usability and Cognitive Testing Other-Interview Format	New
216643	Company Organization Survey - Enterprise Statistics Program (ESP) Other-Draft Protocol	New
216641	Online ACS Mobile Device Other-Demographic Information	New
216596	Questionnaire Pretesting Research - ECON Hub Business Unit Harmonization Team Form and Instruction	New
216576	Decennial Language Research Form and Instruction	New
211844	Various Economic Area Pretesting Activities Other-Response Processes: Electronic Reporting in the Economic C	New
210879	Various Demographic Area Pretesting Activities Other-Opt-In GovDelivery Panel Testing Enclosure	New
210394	Various Economic Area Pretesting Activities Other-Survey of Business Owners Enclosure 5	New
208987	Various Government Pretesting Activities Other-2013 Annual Survey of Public Pensions Pretesting Enclosure	Unchanged

ICR Details

OMB Control No: 0607-0725	ICR Reference No: 201312-0607-004
Status: Historical Active	Previous ICR Reference No: 201306-0607-001
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: Generic Clearance for Questionnaire Pretesting Research
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/24/2014
	Date Received in OIRA: 01/08/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	08/31/2016	08/31/2016
Responses	16,500	0	16,500
Time Burden (Hours)	16,500	0	16,500
Cost Burden (Dollars)	0	0	0

---

Abstract: The research will be used by the Census Bureau and the survey sponsors to improve questionnaires and procedures, reduce respondent burden, and ultimately increase the quality of data collected in Census Bureau censuses and surveys.

---

Authorizing Statute(s): US Code: 13 USC 131, 141, 161, 181, 182, 193, Name of Law: null
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 23743	04/22/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 41029	07/09/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 51

IC Title	Form No.	Form Name
2016 Census Test online questionnaire non-English testing	2016 Census Test protocol	2016 Census Test protocol
NSCG Contact Materials
American Housing Survey Contact and Incentive Focus Groups
2017 Commodity Flow Survey (CFS) Web questionnaire	Protocol	Protocol
Company Organization Survey - Enterprise Statistics Program (ESP)
2016 COMPASS NRFU	2016 NRFU	2016 NRFU
Federal Deposit Insurance Corporation's Survey
2016 Census Student Housing Definition Group Quarters	Student Housing Protocol, Student Housing Apartment Protocol	Student Housing Protocol ,   Student Housing Apartment Protocol
2016 NYCHVS Spanish Translation Research	H-100, Enc. 3, Enc. 2, Enc. 4, Enc. 5	New York City Housing and Vacancy Survey ,   Owner-Occupied Protocol ,   Renter-Occupied Protocol ,   Vacant Unit Protocol ,   Recruitment Screener
2016 ASE	2016 ASC Business Management Practices Module	2016 ASC Business Management Practices Module
Decennial Language Research	Dy-1 (CT4B0, DC3309	2014 Census Test Language Flashcard ,   2015 National Content Test
2016 Census Letter Cognitive Testing
2020 Chinese Korean Bilingual Forms	DF-1 E, TO09 Study Screener	2020 Census Bilingual Korean and Chinese Forms ,   TO09 Study Screener
2015 ASM-RO Worksheet Prototype Debriefings	ASM-RO Debriefing	ASM-RO Debriefing
Factoryless Goods Producers for 2017 Economic Census	NEW FGP questions	NEW FGP questions
2017 Puerto Rico Census Focus Group Pretesting
2016 Annual Survey of Manufactures and 2016 Report of Organization
NACS for 2017 Economic Census: Round 3	Protocol	Protocol
2017 Economic Census New Questions	2017 Economic Census New Questions	2017 Economic Census New Questions
State Government Research and Development (SGRD)
Various Economic Area Pretesting Activities
Various Economic Area Pretesting Activities
Census Business Builder Online Tool
2015 Small Business Lending Survey (SBLS)	SBLS Protocol	SBLS Protocol
Puerto Rico Group Quarters Electronic Transfer Capability Survey	Puerto Rico Group Quarters Electronic Transfer Cap	Puerto Rico Group Quarters Electronic Transfer Capability Survey
North American Products Classification System (NAPCS)	WH-42409	2012 Economic Census
Factoryless Goods Producers (FGP)
Various Demographic Area Pretesting Activities
Usability of the 2017 National Survey of College Graduates (NSCG) online questionnaire
2016 Business R&D and Innovation Survey (BRDIS)	BRDIS Protocol	BRDIS Protocol
AHS Revised Modules Cog Testing	AHS Protocol , AHS Screener	AHS Protocol ,   AHS Screener
Mobile UI Design Framework for Survey Operations – Phase 1, Study 1	Demographics, Mobile Questions, Debriefing Satisfaction	Demographics ,   Mobile Questions ,   Debriefing Satisfaction
AIAN Enrollment Questions	AI Screener, Protocol 1, Protocol 2, Protocol 3, DY-1W-TE1, DY-1W TE2, DY-1W TE3, AN Screener	2017 Census Test Experimental Form 1 ,   2017 Census Test Experimental Form 2 ,   2017 Census Test Experimental Form 3 ,   AN Screener ,   AI Screener ,   Protocol 1 ,   Protocol 2 ,   Protocol 3
SCOPE Confidentiality Language Testing
FY16 Generic Screeners	Internet Screener, Telephone Screener	Internet Screener ,   Telephone Screener
Census User Identification Codes Usability Testing	Satisfaction Questionnaire	Satisfaction Questionnaire
AIAN Tribal Enrollment	AI Screener, AN Screener, AI Moderator Guide, AN Moderator Guide	AI Screener ,   AN Screener ,   AI Moderator Guide ,   AN Moderator Guide
Annual Survey of Entrepreneurs
NCVS SVS
Various Government Pretesting Activities
Group Quarters Electronic Transfer Capability Survey (GQETCS)
2015 Management and Organizational Practices Survey (MOPS)	MP-10002	2015 Management and Organizational Practices Survey (MOPS)
Online ACS Mobile Device
Questionnaire Pretesting Research - ECON Hub Business Unit Harmonization Team	SA-42A (01-30-2015), BRD-1, ACE-1 (Long), SA-44C (01-30-2015), MC-3100, SA-54150A	2012 Annual Capital Expenditures Survey ,   2014 Annual Retail Trade Report ,   2014 Annual Wholesale Trade Report ,   BRDIS State ,   2012 Econimic Census ,   2014 Annual Services Report
2017 Commodity Flow Survey Pretest	CFS-1000	Commodity Flow Survey
2015 National Content Test Usability and Cognitive Testing
2020 Census Billinugal Vietnamese, Russian, and Arabic	D1-F DRAFT	2016 Census Form Vietnamese, Russian, and Arabic
MOPS Usability Testing
Respondent debriefings - Web instrument - 2015 Annual Survey of Manufactures (ASM)	ASM Debriefing	ASM Debriefing
2016 American Community Survey Respondent Burden Testing	Internet Group 2 Version 2, Internet Group 1 Version 1, CAI Group 1 Version 1, CAI Group 2 Version 1, CAI Group 2 Version 2, CAI Group 3 Version 2, Paper Group 3 Version 1, Internet Group 1 Version 2, CAI Group 3 Version 1, Paper Group 3 Version 2, CAI Group 1 Version 2, Internet Group 2 Version 1	Internet Group 2 Version 1 ,   CAI Group 1 Version 1 ,   CAI Group 1 Version 2 ,   Internet Group 1 Version 1 ,   Internet Group 1 Version 2 ,   CAI Group 2 Version 1 ,   CAI Group 2 Version 2 ,   Internet Group 2 Version 2 ,   CAI Group 3 Version 1 ,   CAI Group 3 Version 2 ,   Paper Group 3 Version 1 ,   Paper Group 3 Version 2
2017 Census Test Usability Testing	Demographics, Mobile Experience Questionnaire, Satisfaction questionnaire	Demographics ,   Mobile Experience Questionnaire ,   Satisfaction questionnaire

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	16,500	16,500	0	0	0	0
Annual Time Burden (Hours)	16,500	16,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/08/2014

---