Information Collection

2017 American Community Survey (ACS) Revised Mailing Materials Cognitive Interviews

IC 224257 under ICR 201402-0690-001 · OMB 0690-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment IV - Consent Form.docx	Other-Consent Form
Attachment V - Recruitment Eligibility Screeners.docx	Other-Recruitment Eligibility Screen
ACS-M ACS Revised Mailing Material Protocol Attachment III - ACS Revised Mailing Materials Protocol.docx	Form and Instruction
Attachment I - 2017 ACS Revised Mailing Materials.pdf ACS Mailing Material	IC Document
Attachment II - Recruitment Advertisements.pdf Recruitment Advertisements	IC Document
ACS Mail Materials OMB Memo_FINAL 102616.docx OMB Memo	IC Document

IC Title:

2017 American Community Survey (ACS) Revised Mailing Materials Cognitive Interviews

Agency IC Tracking Number:

Census

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consent Form			Attachment IV - Consent Form.docx	Yes	No	Fillable Printable
Other-Recruitment Eligibility Screeners			Attachment V - Recruitment Eligibility Screeners.docx	Yes	No	Fillable Fileable
Form and Instruction	ACS-M	ACS Revised Mailing Material Protocol	Attachment III - ACS Revised Mailing Materials Protocol.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 140

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	140	140
Annual IC Time Burden (Hours)	39	39
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ACS Mailing Material	Attachment I - 2017 ACS Revised Mailing Materials.pdf	11/02/2016
Recruitment Advertisements	Attachment II - Recruitment Advertisements.pdf	11/02/2016
OMB Memo	ACS Mail Materials OMB Memo_FINAL 102616.docx	11/02/2016

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