Information Collection

ACS Respondent Perceptions of Burden

IC 227780 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 ACS Respondent Perceptions of Burden	Form and Instructi
1 Paper Survey Enclosure 4 - informational copy of 2017 questionnaire.pdf	Form and Instruction
2 Follow Up Questions Enclosure 5 - Survey Questions.docx	Form
Cover Memo.docx OMB Memo	IC Document
Enclosure 1 - Telephone Script.docx Telephone Recruitment Script	IC Document
Enclosure 2 - Recruitment advertisement text.docx Recruitment Ads	IC Document
Enclosure 3 - Additional Screener Question.docx Additional Screener Question	IC Document
Enclosure 6A - Protocol A.docx Protocol Version A	IC Document
Enclosure 6B - Protocol B.docx Protocol Version B	IC Document
Enclosure 7 - Consent Form.docx Consent Form	IC Document

IC Title:

ACS Respondent Perceptions of Burden

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	1	Paper Survey	Enclosure 4 - informational copy of 2017 questionnaire.pdf		No		Fillable Fileable
Form	2	Follow Up Questions	Enclosure 5 - Survey Questions.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 96

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	96	96
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	Cover Memo.docx	08/02/2017
Telephone Recruitment Script	Enclosure 1 - Telephone Script.docx	08/02/2017
Recruitment Ads	Enclosure 2 - Recruitment advertisement text.docx	08/02/2017
Additional Screener Question	Enclosure 3 - Additional Screener Question.docx	08/02/2017
Protocol Version A	Enclosure 6A - Protocol A.docx	08/02/2017
Protocol Version B	Enclosure 6B - Protocol B.docx	08/02/2017
Consent Form	Enclosure 7 - Consent Form.docx	08/02/2017

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