AIAN Enrollment Questions

Generic Clearance for Questionnaire Pretesting Research

OMB: 0607-0725

IC ID: 221552

Information Collection (IC) Details

View Information Collection (IC)

AIAN Enrollment Questions
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form DY-1W-TE1 2017 Census Test Experimental Form 1 DY-1W_TE1 (encl 1).pdf Yes Yes Paper Only
Form DY-1W TE2 2017 Census Test Experimental Form 2 DY-1W_TE2 (encl 2).pdf Yes Yes Paper Only
Form DY-1W TE3 2017 Census Test Experimental Form 3 DY-1W_TE3 (encl 3).pdf Yes Yes Paper Only
Form and Instruction AN Screener AN Screener CI_Screener_Questions_AN 051216 (encl 5).docx Yes Yes Paper Only
Form AI Screener AI Screener CI_Screener_Questions_AI IMCSA 051216 (encl 6).docx Yes Yes Paper Only
Form and Instruction Protocol 1 Protocol 1 AIAN Tribal Enrollment Q Protocol 1 051316 (encl 7).docx Yes Yes Paper Only
Form and Instruction Protocol 2 Protocol 2 AIAN Tribal Enrollment Q Protocol 2 051316 (encl 8).docx Yes Yes Paper Only
Form and Instruction Protocol 3 Protocol 3 AIAN Tribal Enrollment Q Protocol 3 051316 (encl 9).docx Yes Yes Paper Only

General Government Central Records & Statistical Mgt

 

63 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 63 0 63 0 0 0
Annual IC Time Burden (Hours) 90 0 90 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Memo AIAN TEQ Cog Research OMB Letter 051216.docx 05/17/2016
Recruitment Info Craigslist Ads + Recruitment Flyers + Tribal Publication Ads 051316 (encl 4).docx 05/17/2016
Consent Form Cognitive Interview Consent Form AIAN (encl 10).docx 05/17/2016
AIAN TEQ Cog Research REV AIAN TEQ Cog Research OMB Letter 060816 rlt response clean.docx 07/07/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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