American Community Survey (ACS) Respondent Comment/Feedback

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⚠️ Notice: This information collection may be referencing outdated material.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 2017 ACS form American Community Survey (ACS) Respondent Comment/Feedback Form
Enclosure 3-Round 2 Protocol.docx Instruction
2017 ACS form 2017 ACS form Enclosure 4 - informational copy of 2017 questionnaire.pdf Form
Comment and Feedba Comment and Feedback Question Enclosure 5-Respondent Comment and Feedback Questions.pdf Form
ACS Respondent-Comment Feedback_Cover Memo.docx Memo IC Document
Enclosure 1-Round 1 Protocol with ACS Burden Questions.docx Enclosure 1 IC Document
Enclosure 2- Round 1 Protocol with Respondent Comment-Feedback Questions.docx Enclosure 2 IC Document
Enclosure 6 - Additional Screener Question.docx Enclosure 6 IC Document
Enclosure 7 - Recruitment advertisement text.docx Enclosure 7 IC Document
Enclosure 8 - Consent Form.docx Enclosure 8 IC Document

Information Collection (IC) Details

IC Title:	American Community Survey (ACS) Respondent Comment/Feedback	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 13 CFR U.S.C. §§ 141 and 193 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	2017 ACS form	2017 ACS form	Enclosure 4 - informational copy of 2017 questionnaire.pdf	Yes	Yes	Printable Only
Instruction			Enclosure 3-Round 2 Protocol.docx	Yes	Yes	Printable Only
Form	Comment and Feedback Question	Comment and Feedback Question	Enclosure 5-Respondent Comment and Feedback Questions.pdf	Yes	Yes	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	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	35	35
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Memo	ACS Respondent-Comment Feedback_Cover Memo.docx	01/19/2018
Enclosure 1	Enclosure 1-Round 1 Protocol with ACS Burden Questions.docx	01/19/2018
Enclosure 2	Enclosure 2- Round 1 Protocol with Respondent Comment-Feedback Questions.docx	01/19/2018
Enclosure 6	Enclosure 6 - Additional Screener Question.docx	01/19/2018
Enclosure 7	Enclosure 7 - Recruitment advertisement text.docx	01/19/2018
Enclosure 8	Enclosure 8 - Consent Form.docx	01/19/2018

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