2016 American Community Survey Respondent Burden Testing

Generic Clearance for Questionnaire Pretesting Research

OMB: 0607-0725

IC ID: 221263

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
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IC Document
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IC Document
Information Collection (IC) Details

View Information Collection (IC)

2016 American Community Survey Respondent Burden Testing
 
New
 
Voluntary
 
13 CFR 141, 193  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Internet Group 2 Version 1 Internet Group 2 Version 1 Attachment H 2016 ACS Respondent Burden Testing_FINAL Protocol_Internet Group 2 Version 1_to CB_042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 1 Version 1 CAI Group 1 Version 1 Attachment B 2016 ACS Respondent Burden Testing_FINAL Protocol_ CAI Group 1 Version 1_to CB 042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 1 Version 2 CAI Group 1 Version 2 Attachment C 2016 ACS Respondent Burden Testing_FINAL Protocol_CAI Group 1 Version 2_to CB 042516.docx Yes Yes Paper Only
Form and Instruction Internet Group 1 Version 1 Internet Group 1 Version 1 Attachment D 2016 ACS Respondent Burden Testing_FINAL Protocol_Internet Group 1 Version 1_to CB 042516.docx Yes Yes Paper Only
Form and Instruction Internet Group 1 Version 2 Internet Group 1 Version 2 Attachment E 2016 ACS Respondent Burden Testing_FINALT Protocol_Internet Group 1 Version 2_to CB 042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 2 Version 1 CAI Group 2 Version 1 Attachment F 2016 ACS Respondent Burden Testing_FINAL Protocol_CAI Group 2 Version 1_to CB_042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 2 Version 2 CAI Group 2 Version 2 Attachment G 2016 ACS Respondent Burden Testing_FINAL Protocol_CAI Group 2 Version 2_ to CB_042516.docx Yes Yes Paper Only
Form and Instruction Internet Group 2 Version 2 Internet Group 2 Version 2 Attachment I 2016 ACS Respondent Burden Testing_FINAL Protocol_Internet Group 2 Version 2_to CB_042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 3 Version 1 CAI Group 3 Version 1 Attachment J 2016 ACS Respondent Burden Testing_FINAL Protocol_CAI Group 3 Version 1_to CB_042516.docx Yes Yes Paper Only
Form and Instruction CAI Group 3 Version 2 CAI Group 3 Version 2 Attachment K 2016 ACS Respondent Burden Testing_FINAL Protocol_DRAFT CAI Group 3 Version 2_to CB_042516.docx Yes Yes Paper Only
Form and Instruction Paper Group 3 Version 1 Paper Group 3 Version 1 Attachment L 2016 ACS Respondent Burden Testing_FINAL Protocol_Paper Group 3 Version 1_to CB_042516.docx Yes Yes Paper Only
Form and Instruction Paper Group 3 Version 2 Paper Group 3 Version 2 Attachment M 2016 ACS Respondent Burden Testing_FINAL Protocol_Paper Group 3 Version 2_to CB_042516.docx Yes Yes Paper Only

General Government Central Records & Statistical Mgt

 

72 0
   
Individuals or Households
 
   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 72 0 72 0 0 0
Annual IC Time Burden (Hours) 75 0 75 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recruitment Screener Attachment A ACS Respondent Burden Testing_FINAL Recruitment Plan_to CB 042516.docx 04/26/2016
Roster Attachment N ACS Cog Test CAI Roster_revised_042516.doc 04/26/2016
CAI_V1 Attachment O CAI_V1_Group 1 and 2.docx 04/26/2016
CAI_V2 Attachment P CAI_V2_Group 1 and 2.docx 04/26/2016
CAI_V1_Group 3 Attachment Q CAI_V1_Group 3.doc 04/26/2016
CAI_V2 Group 3 Attachment R CAI_V2_Group 3.doc 04/26/2016
Internet Version 1 Group 1 Attachment S Group 1 Version 1 Internet Screens.pdf 04/26/2016
Interent Group 1 Version 2 Attachment T Group 1 Version 2 Internet Screens.pdf 04/26/2016
Internet Group 2 Version 1 Attachment U Group 2 Version 1 Internet Screens.pdf 04/26/2016
Internet Group 2 Version 2 Attachment V Group 2 Version 2 Internet Screens.pdf 04/26/2016
Paper Group 3 Version 1 Attachment W Paper Questionnaire Group 3 Version 1 ACS-1(X)G3V1_final.pdf 04/26/2016
Paper Group 3 Verion 2 Attachment X Paper Questionnaire Group 3 Version 2 ACS-1(X)G3V2_final.pdf 04/26/2016
Consent Form Attachment Y 2016 ACS Respondent Burden Testing_FINAL Consent Form 042516.doc 04/26/2016
Memo OMB Memo for Westat Cognitive Testing 5-20-2016.docx 05/20/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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