Information Collection

2017 Puerto Rico Census Focus Group Pretesting

IC 220989 under ICR 201312-0607-004 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Enclosure 1_Moderators Guide.docx	Instruction
OMB letter_2017 Puerto Rico Census Test Focus Groups.pdf Memo	IC Document
Enclosure 2_Prototype Internet instrument address collection screens.pptx Prototype 1	IC Document
Enclosure 3_Prototype paper questionnaire address collection format.pdf Prototype 2	IC Document
Enclosure 4_Recruitment Plan and Screener questionnaire.docx Recruitment Plan	IC Document
Enclosure 5_Consent form.docx Consent Form	IC Document

IC Title:

2017 Puerto Rico Census Focus Group Pretesting

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 13 CFR Sections 141, 193, 221, and 22 (To search for a specific CFR, visit the Code of Federal Regulations.)

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
Instruction			Enclosure 1_Moderators Guide.docx		Yes	Yes	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

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	90	90
Annual IC Time Burden (Hours)	198	198
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo	OMB letter_2017 Puerto Rico Census Test Focus Groups.pdf	04/08/2016
Prototype 1	Enclosure 2_Prototype Internet instrument address collection screens.pptx	04/08/2016
Prototype 2	Enclosure 3_Prototype paper questionnaire address collection format.pdf	04/08/2016
Recruitment Plan	Enclosure 4_Recruitment Plan and Screener questionnaire.docx	04/08/2016
Consent Form	Enclosure 5_Consent form.docx	04/08/2016

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