Information Collection

Cognitive Testing of Supplemental Fraud Survey - Crowdsourcing

IC 223275 under ICR 201510-1121-007 · OMB 1121-0325.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cognitive Testing of Supplemental Fraud Survey - Crowdsourcing	Form and Instruction
Screener Instrument for Supplement Fraud Survey Screener Instrument.docx	Form and Instruction
SFS cog testing generic clearance_crowdsourcing.docx OMB Memo on Cognitive Testing for SFS using Crowdsourcing	IC Document
Combined Appendices.docx Appendices for SFS Cognitive Testing	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 Instrument for Supplement Fraud Survey	Screener Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Citizen Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo on Cognitive Testing for SFS using Crowdsourcing	SFS cog testing generic clearance_crowdsourcing.docx	08/31/2016
Appendices for SFS Cognitive Testing	Combined Appendices.docx	08/31/2016

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