Information Collection

Special Census Program

IC 219039 under ICR 201511-0607-002 · OMB 0607-0368.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0368 can be found here:

Documents and Forms

Document Name Document Type
Form SC-1 Special Census Program Form and Instruction
Attachment M_SC-1(F).pdf Instruction
Attachment N_SC-31.pdf Instruction
Attachment O_SC-26.pdf Other-Notice of Visit
Attachment P_SC-901.pdf Other-Enumerator's Notes
Attachment Q_SC-3309.pdf Instruction
SC-1 Enumerator Questionnaire Attachment A_SC-1.pdf Form and Instruction
SC-1 (Supp) Enumeration Continuation Questionnaire Attachment B_SC-1(supp).pdf Form
SC-1 (phone) Phone/WYC Questionnaire Attachment C_SC-1(phone).pdf Form and Instruction
SC-2 Special Census Individual Census Report Attachment D_SC-2.pdf Form
SC-3 (RI) Enumeration Reinterview Form Attachment E_SC-3.pdf Form and Instruction
SC-116 GQ Enumeration Control Record Attachment F_SC-116.pdf Form
SC-117 TL Enumeration Record Attachment G_SC-117.pdf Form
SC-351 GQ Initail Contact Checklist Attachment H_SC-351.pdf Form and Instruction
SC-920 Address Listing Page Attachment I_SC-920.pdf Form
SC-921 (HU) Housing Unit Add Page Attachment J_SC-921(HU).pdf Form and Instruction
SC-921 (GQ) Group Quarter Add Page Attachment K_SC-921(GQ).pdf Form
SC -921 (TU) Transitory Unit Add Page Attachment L_SC-921(TU).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Special Census Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	SC-1	Enumerator Questionnaire	Attachment A_SC-1.pdf	No	Paper Only
Form	SC-1 (Supp)	Enumeration Continuation Questionnaire	Attachment B_SC-1(supp).pdf	No	Paper Only
Form and Instruction	SC-1 (phone)	Phone/WYC Questionnaire	Attachment C_SC-1(phone).pdf	No	Paper Only
Form	SC-2	Special Census Individual Census Report	Attachment D_SC-2.pdf	No	Paper Only
Form and Instruction	SC-3 (RI)	Enumeration Reinterview Form	Attachment E_SC-3.pdf	No	Paper Only
Form	SC-116	GQ Enumeration Control Record	Attachment F_SC-116.pdf	No	Paper Only
Form	SC-117	TL Enumeration Record	Attachment G_SC-117.pdf	No	Paper Only
Form and Instruction	SC-351	GQ Initail Contact Checklist	Attachment H_SC-351.pdf	No	Paper Only
Form	SC-920	Address Listing Page	Attachment I_SC-920.pdf	No	Paper Only
Form and Instruction	SC-921 (HU)	Housing Unit Add Page	Attachment J_SC-921(HU).pdf	No	Paper Only
Form	SC-921 (GQ)	Group Quarter Add Page	Attachment K_SC-921(GQ).pdf	No	Paper Only
Form and Instruction	SC -921 (TU)	Transitory Unit Add Page	Attachment L_SC-921(TU).pdf	No	Paper Only
Instruction			Attachment M_SC-1(F).pdf	No	Paper Only
Instruction			Attachment N_SC-31.pdf	No	Paper Only
Other-Notice of Visit			Attachment O_SC-26.pdf	No	Paper Only
Other-Enumerator's Notes			Attachment P_SC-901.pdf	No	Paper Only
Instruction			Attachment Q_SC-3309.pdf	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 248,430	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	248,430	248,430
Annual IC Time Burden (Hours)	52,998	52,998
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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