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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.