Information Collection

CBECS Pretest

IC 232956 under ICR 201601-1905-002 · OMB 1905-0186.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1905-0186 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey Questions.docx	Other-null
ObservationForm_pretest.docx Interviewer Observation Form	IC Document
Template Pretest Generic Clearance-Sep10.docx Template	IC Document
Respondent_ID Form.docx Respondent ID Contact Form	IC Document
DOE Roadmap letter_pretest.docx Welcome Script	IC Document
Contact pretest intro script.docx Contact Pretest Introduction script	IC Document
2018 Authorization Letter_pretest.docx DOE Authorization letter	IC Document

IC Title:

CBECS Pretest

Agency IC Tracking Number:

1905-0186

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320

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
Other-null			Survey Questions.docx		No		Fillable Fileable Signable

Line of Business: Energy

Subfunction: Energy Supply

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 464

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	464	464
Annual IC Time Burden (Hours)	155	155
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Interviewer Observation Form	ObservationForm_pretest.docx	09/10/2018
Template	Template Pretest Generic Clearance-Sep10.docx	09/10/2018
Respondent ID Contact Form	Respondent_ID Form.docx	09/10/2018
Welcome Script	DOE Roadmap letter_pretest.docx	09/10/2018
Contact Pretest Introduction script	Contact pretest intro script.docx	09/10/2018
DOE Authorization letter	2018 Authorization Letter_pretest.docx	09/10/2018

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