Information Collection

Cognitive Testing of the Supplemental Fraud Survey (SFS)

IC 225965 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 the Supplemental Fraud Survey (SFS)	Form and Instruction
V3 Supplemental Fraud Survey (SFS) V3_Cog_Int_Protocol_022417.pdf	Form and Instruction
V4 Supplemental Fraud Survey (SFS) SFS_V4_CI_Protocol_REV_022417.pdf	Form and Instruction
SFS cog testing generic clearance_f2f interviews_final memo.docx Memo to OMB on Supplemental Fraud Supplement	IC Document
SFS cog testing generic clearance_f2f interviews_appendices.pdf SFS Attachments	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	V3 Supplemental Fraud Survey (SFS)	V3_Cog_Int_Protocol_022417.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	V4 Supplemental Fraud Survey (SFS)	SFS_V4_CI_Protocol_REV_022417.pdf		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

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

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB on Supplemental Fraud Supplement	SFS cog testing generic clearance_f2f interviews_final memo.docx	03/03/2017
SFS Attachments	SFS cog testing generic clearance_f2f interviews_appendices.pdf	03/03/2017

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