2017 American Community Survey Respondent Burden Testing

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form Paper Survey Quest 2017 American Community Survey Respondent Burden Testing Form
Paper Survey Quest Paper Survey Questions Attachment G_Paper Survey Questions.pdf Form
Interviewer-Admini Interviewer-Administered Survey Questions Attachment E_Interviewer-Administered Survey Questions.doc Form
Interviewer-Admini Interviewer-Administered Roster Questions Attachment F_Interviewer-Administered Roster Questions.doc Form
Attachment A_ACS Cognitive Testing to Reduce the Burden and Difficulty of Questions Research Goals, Recruiting Requirements, and Question Wordi.docx Research Goals, Recruiting Requirements, and Question Wording for the Second Round of Testing IC Document
Attachment B_ACS Respondent Burden Testing - Recruitment Screener and Advertisements.docx Recruitment Screener and Advertisements IC Document
Attachment C_ACS Cognitive Testing Protocol (Paper).docx Cognitive Interview Protocol (Paper) IC Document
Attachment D_ACS Cognitive Testing Protocol (CAI).docx Cognitive Testing Protocol (CAI) IC Document
OMB Memo Weeks Worked and Income 10242016.docx OMB Memo Weeks Worked and Income Testing IC Document

Information Collection (IC) Details

IC Title:	2017 American Community Survey Respondent Burden Testing	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Paper Survey Questions	Paper Survey Questions	Attachment G_Paper Survey Questions.pdf	Yes	No	Fillable Fileable
Form	Interviewer-Administered Survey Questions	Interviewer-Administered Survey Questions	Attachment E_Interviewer-Administered Survey Questions.doc	Yes	No	Fillable Fileable
Form	Interviewer-Administered Roster Questions	Interviewer-Administered Roster Questions	Attachment F_Interviewer-Administered Roster Questions.doc	Yes	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 48	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	48	48
Annual IC Time Burden (Hours)	46	46
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Research Goals, Recruiting Requirements, and Question Wording for the Second Round of Testing	Attachment A_ACS Cognitive Testing to Reduce the Burden and Difficulty of Questions Research Goals, Recruiting Requirements, and Question Wordi.docx	10/27/2016
Recruitment Screener and Advertisements	Attachment B_ACS Respondent Burden Testing - Recruitment Screener and Advertisements.docx	10/27/2016
Cognitive Interview Protocol (Paper)	Attachment C_ACS Cognitive Testing Protocol (Paper).docx	10/27/2016
Cognitive Testing Protocol (CAI)	Attachment D_ACS Cognitive Testing Protocol (CAI).docx	10/27/2016
OMB Memo Weeks Worked and Income Testing	OMB Memo Weeks Worked and Income 10242016.docx	10/27/2016

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