Information Collection

ORS Incumbent Survey Development Test

IC 222647 under ICR 201408-1220-002 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment A ORS Incumbent Test Stylized Questionnaire ORS Incumbent Survey Development Test	Form and Instruction
Form Attachment B - Inc Diary Instructions ORS Incumbent Survey Development Test	Form and Instruction
Form Attachment C Incumbent Diary Form ORS Incumbent Survey Development Test	Form
Form Attachment D ORS Form ORS Incumbent Survey Development Test	Form and Instruction
Form Appendix A Screening Questions ORS Incumbent Survey Development Test	Form
Form Appendix C -- Cons Consent Form ORS Incumbent Survey Development Test	Form
Form Appendix D Debriefing Questions ORS Incumbent Survey Development Test	Form
Attachment A ORS Incumbent Test Stylized Questionnaire Attachment-A_ORS_Incumbent_Test_Stylized_Questionnaire_7-25-16.docx	Form and Instruction
Attachment B - Inc Diary Instructions Attachment-B_ORS Incumbent Diary Instructions_7-25-16.docx	Form and Instruction
Attachment C Incumbent Diary Form Attachment-C_ORS_Incumbent_Diary_Blank.xlsx	Form
Attachment D ORS Form Attachment-D_ORS_form2016.pdf	Form and Instruction
Appendix A Screening Questions Appendix A - Screening Questions.docx	Form
Appendix C -- Cons Consent Form Appendix C - Consent Form.docx	Form
Appendix D Debriefing Questions Appendix D - Debriefing Questions.docx	Form
Note to Reviewer - ORS_Incumbent_Survey.docx Note to Reviewer	IC Document

IC Title:

ORS Incumbent Survey Development Test

Agency IC Tracking Number:

21619

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment A	Yes	No	Printable Only
Form and Instruction	Attachment B - Incumbent Diary	Yes	No	Printable Only
Form	Attachment C	Yes	No	Printable Only
Form and Instruction	Attachment D	Yes	No	Printable Only
Form	Appendix A	Yes	No	Printable Only
Form	Appendix C -- Consent Form	Yes	No	Printable Only
Form	Appendix D	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 43

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	73	73
Annual IC Time Burden (Hours)	37	37
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer		07/27/2016

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

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