MEPS–IC Cog 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⚠️ Notice: This information collection may be referencing outdated material.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 1 MEPS–IC Cog Testing Form and Instructi
1 MEPS-10 meps10_050417_D10.pdf Form and Instruction
2 MEPS-10S meps10s_032917_D6.pdf Form and Instruction
3 MEPS-11 meps11_050417_D7.pdf Form and Instruction
4 MEPS-11S meps11s_041317_D4.pdf Form and Instruction
MEPS_IC_OMB_letter_10.05.2017.docx OMB Memo IC Document
MEPS Interview Protocol 100517.docx Protocol IC Document

Information Collection (IC) Details

IC Title:	MEPS–IC Cog 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?	Electronic Capability
Form and Instruction	1	MEPS-10	meps10_050417_D10.pdf	No	Fillable Fileable
Form and Instruction	2	MEPS-10S	meps10s_032917_D6.pdf	No	Fillable Fileable
Form and Instruction	3	MEPS-11	meps11_050417_D7.pdf	No	Fillable Fileable
Form and Instruction	4	MEPS-11S	meps11s_041317_D4.pdf	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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	50	50
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	MEPS_IC_OMB_letter_10.05.2017.docx	10/06/2017
Protocol	MEPS Interview Protocol 100517.docx	10/06/2017

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