2017 Puerto Rico Census Focus Group Pretesting

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.