Information Collection

Cognitive Testing under the National Crime Victimization Survey (NCVS) Redesign Generic Clearance

IC 222169 under ICR 201510-1121-007 · OMB 1121-0325.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cognitive Testing under the National Crime Victimization Survey (NCVS) Redesign Generic Clearance	Form and Instruction
Screener Testing Instrument and Protocol Attachment A - Instruments and Protocols.docx	Form and Instruction
Preliminary Crime Incident Report Items For Cognitive Te Attachment C - Crime Incident Report Items.docx	Form and Instruction
NCVS Redesign - Memo requesting clearance for cognitive testing 6.23.16.docx Memo to OMB on Cognitive Testing for NCVS Redesign	IC Document
NCVS Redesign - OMB memo attachments combined.pdf Cognitive Testing for NCVS Redesign Attachments	IC Document
NCVS Redesign - Memo requesting clearance for cognitive testing 080116.docx Revised Memo to OMB on Cognitive Testing for NCVS Redesign	IC Document

IC Title:

Agency IC Tracking Number:

BJS

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Screener Testing Instrument and Protocol	Attachment A - Instruments and Protocols.docx		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Preliminary Crime Incident Report Items For Cognitive Testing	Attachment C - Crime Incident Report Items.docx		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 490

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	490	490
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB on Cognitive Testing for NCVS Redesign	NCVS Redesign - Memo requesting clearance for cognitive testing 6.23.16.docx	06/23/2016
Cognitive Testing for NCVS Redesign Attachments	NCVS Redesign - OMB memo attachments combined.pdf	06/23/2016
Revised Memo to OMB on Cognitive Testing for NCVS Redesign	NCVS Redesign - Memo requesting clearance for cognitive testing 080116.docx	08/02/2016

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