Information Collection

State Government R&D Survey

IC 45082 under ICR 201602-0607-003 · OMB 0607-0933.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0933 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Survey Frame Revie State Government R&D Survey	Form
Attachment C - FY 2016 SGRD Reference Copy Questionnaire.pdf	Other-Reference Copy of Electronic I
Attachment D - SGRD Governors Letter.pdf	Other-Governors Letter
Attachment E - State Coordinator Email.docx	Other-Email to State Coordinators
Attachment F - Agency Email.docx	Other-Email to State Agency Responde
Attachment G - Business Help Site.docx	Other-Statement of Survey Purpose fr
Survey Frame Revie Survey Frame Review Module Attachment A - Survey Frame Review Module.docx	Form
Electronic Instrum Electronic Instrument - State Agency Respondents Attachment B - Centurion Collection Instrument.pdf	Form
Attachment I - List of Individual Cognitive and Usability Testing Consultations.docx List of Consultants	IC Document

IC Title:

State Government R&D Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Survey Frame Review Module	Survey Frame Review Module	Attachment A - Survey Frame Review Module.docx	Yes	Yes	Fillable Fileable
Form	Electronic Instrument - State Agency Respondents	Electronic Instrument - State Agency Respondents	Attachment B - Centurion Collection Instrument.pdf	Yes	Yes	Fillable Fileable
Other-Reference Copy of Electronic Instrument			Attachment C - FY 2016 SGRD Reference Copy Questionnaire.pdf	Yes	Yes	Fillable Fileable
Other-Governors Letter			Attachment D - SGRD Governors Letter.pdf	Yes	Yes	Fillable Fileable
Other-Email to State Coordinators			Attachment E - State Coordinator Email.docx	Yes	Yes	Fillable Fileable
Other-Email to State Agency Respondents			Attachment F - Agency Email.docx	Yes	Yes	Fillable Fileable
Other-Statement of Survey Purpose from Business Help Site			Attachment G - Business Help Site.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 604

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	604	328	276
Annual IC Time Burden (Hours)	1,056	514	542
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
List of Consultants	Attachment I - List of Individual Cognitive and Usability Testing Consultations.docx	02/24/2016

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