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AIAN Tribal Enrollment
Generic Clearance for Questionnaire Pretesting Research
OMB: 0607-0725
IC ID: 219050
OMB.report
DOC/CENSUS
OMB 0607-0725
ICR 201312-0607-004
IC 219050
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:
2022-10-14 - Extension without change of a currently approved collection
2019-09-30 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form AI Screener
AIAN Tribal Enrollment
Form
AI Screener AI Screener
FG_Screener_Questions_AI L48 111915.docx
Form
AN Screener AN Screener
FG_Screener_Questions_AN 111915.docx
Form
AI Moderator Guide AI Moderator Guide
AIAN EQ Moderator Guide AI 112015.docx
Form
AN Moderator Guide AN Moderator Guide
AIAN EQ Moderator Guide AN 112015.docx
Form
Focus Group Consent Form AIAN.docx
Consent form
IC Document
Craigslist Ads + Recruitment Flyers + Tribal Publication Ads.docx
Advertisements
IC Document
AIAN TEQ Research OMB Letter 111915.docx
Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
AIAN Tribal Enrollment
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
13 CFR 141, 193 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
AI Screener
AI Screener
FG_Screener_Questions_AI L48 111915.docx
Yes
Yes
Paper Only
Form
AN Screener
AN Screener
FG_Screener_Questions_AN 111915.docx
Yes
Yes
Paper Only
Form
AI Moderator Guide
AI Moderator Guide
AIAN EQ Moderator Guide AI 112015.docx
Yes
Yes
Paper Only
Form
AN Moderator Guide
AN Moderator Guide
AIAN EQ Moderator Guide AN 112015.docx
Yes
Yes
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:
88
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
88
0
88
0
0
0
Annual IC Time Burden (Hours)
231
0
231
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Consent form
Focus Group Consent Form AIAN.docx
11/20/2015
Advertisements
Craigslist Ads + Recruitment Flyers + Tribal Publication Ads.docx
11/20/2015
Memo
AIAN TEQ Research OMB Letter 111915.docx
11/24/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.