Information Collection

American Community Survey (ACS) Respondent Comment/Feedback

IC 229783 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⚠️ Notice: This information collection may be referencing outdated material.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 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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.