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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ACS Respondent Perceptions of Burden	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.